Prevalence of primary aldosteronism in primary care: a cross-sectional study
| Autor: | Marion C J Biermans, Jacques W.M. Lenders, Jaap Deinum, Tjard Schermer, Bianca W. M. Schalk, Wim J C de Grauw, Hans Jhj Bor, Sabine C Käyser |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Cross-sectional study Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Secondary hypertension Primary care 030204 cardiovascular system & hematology Sodium Chloride 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Primary aldosteronism All institutes and research themes of the Radboud University Medical Center Internal medicine Hyperaldosteronism Renin medicine Prevalence Humans Mass Screening 030212 general & internal medicine Infusions Intravenous Aldosterone Aged Netherlands Primary Health Care business.industry Research Guideline Middle Aged medicine.disease Confidence interval Blood pressure Cross-Sectional Studies chemistry Hypertension Practice Guidelines as Topic Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5] Female Family Practice business |
| Zdroj: | British Journal of General Practice, 68, 667, pp. E114-E122 British Journal of General Practice, 68, E114-E122 |
| ISSN: | 0960-1643 |
| Popis: | BackgroundPrimary aldosteronism (PA) is the most frequent cause of secondary hypertension. Reported prevalences of PA vary considerably because of a large heterogeneity in study methodology.AimTo examine the proportion of patients with PA among patients with newly diagnosed, never treated hypertension.Design and settingA cross-sectional study set in primary care.MethodGPs measured aldosterone and renin in adult patients with newly diagnosed, never treated hypertension. Patients with elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration underwent a saline infusion test to confirm or exclude PA. The source population was meticulously assessed to detect possible selection bias.ResultsOf 3748 patients with newly diagnosed hypertension, 343 patients were screened for PA. In nine out of 74 patients with an elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration the diagnosis of PA was confirmed by a saline infusion test, resulting in a prevalence of 2.6% (95% confidence interval = 1.4 to 4.9). All patients with PA were normokalaemic and 8 out of 9 patients had sustained blood pressure >150/100 mmHg. Screened patients were younger (PPConclusionIn this study a prevalence of PA of 2.6% in a primary care setting was established, which is lower than estimates reported from other primary care studies so far. This study supports the screening strategy as recommended by the Endocrine Society Clinical Practice Guideline. The low proportion of screened patients (9.2%), of the large cohort of eligible patients, reflects the difficulty of conducting prevalence studies in primary care clinical practice. |
| Databáze: | OpenAIRE |
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