Yin Yu Lim1, Jimmy Shen2, Peter J Fuller3, Jun Yang4. 1. Medical student (year four), School of Clinical Sciences, Monash University, Clayton, Vic 2. MBBS, PhD, FRACP, Consultant Endocrinologist, Monash Health and Research Fellow, Hudson Institute of Medical Research, Clayton, Vic 3. AM MBBS, BMedSci, PhD, FRACP, Head of Department of Endocrinology, Monash Health; Head of Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Vic 4. MBBS, PhD, FRACP, Research Fellow, School of Clinical Sciences, Monash University; Consultant Endocrinologist, Monash Health; Head of Endocrine Hypertension Services, Hudson Institute of Medical Research, Clayton, Vic. jun.yang@hudson.org.au
Abstract
BACKGROUND: Primary aldosteronism is the most common specifically treatable and potentially curable cause of hypertension. OBJECTIVE: The aim of this study was to analyse the referral pattern and disease characteristics of patients with hypertension and suspected primary aldosteronism. METHODS: We prospectively collected clinical data from patients who attended the Endocrine Hypertension Service (EHS) at Monash Health from May 2016 to May 2017. RESULTS: Of 87 patients, 69.2% had indications for primary aldosteronism screening in the primary care setting, although only 3.7% were actually screened. At the time of referral to the EHS, 61% had hypertension for over 10 years and 42% of the patients with primary aldosteronism had associated end-organ damage. Targeted treatment of primary aldosteronism led to biochemical and clinical improvement in all patients. DISCUSSION: The diagnosis of primary aldosteronism is currently delayed and associated with significant end-organ damage. Increased awareness of primary aldosteronism and its screening indications in primary and tertiary care is needed for earlier diagnosis and improved outcomes.
BACKGROUND: Primary aldosteronism is the most common specifically treatable and potentially curable cause of hypertension. OBJECTIVE: The aim of this study was to analyse the referral pattern and disease characteristics of patients with hypertension and suspected primary aldosteronism. METHODS: We prospectively collected clinical data from patients who attended the Endocrine Hypertension Service (EHS) at Monash Health from May 2016 to May 2017. RESULTS: Of 87 patients, 69.2% had indications for primary aldosteronism screening in the primary care setting, although only 3.7% were actually screened. At the time of referral to the EHS, 61% had hypertension for over 10 years and 42% of the patients with primary aldosteronism had associated end-organ damage. Targeted treatment of primary aldosteronism led to biochemical and clinical improvement in all patients. DISCUSSION: The diagnosis of primary aldosteronism is currently delayed and associated with significant end-organ damage. Increased awareness of primary aldosteronism and its screening indications in primary and tertiary care is needed for earlier diagnosis and improved outcomes.
Authors: Karanjeet Chauhan; Eitan Schachna; Renata Libianto; Jessica Ryan; Holly Hutton; Peter J Fuller; Scott Wilson; Peter G Kerr; Jun Yang Journal: J Nephrol Date: 2022-02-23 Impact factor: 4.393