PREVELENCE OF PRIMARY ALDOSTERONISM IN AN URBAN HYPERTENSIVE POPULATION

Area of Science:

• Endocrinology
• Hypertension Management
• Primary Care Medicine

Background:

• Primary aldosteronism (PA) is a significant cause of secondary hypertension.
• Early detection and treatment of PA can prevent cardiovascular complications.
• Current screening practices in primary care settings require further investigation.

Purpose of the Study:

• To determine the prevalence of primary aldosteronism (PA) in a primary care hypertensive patient population.
• To identify clinical indicators that warrant screening for PA in primary care.

Main Methods:

• Prospective screening of 296 hypertensive patients using the aldosterone:renin ratio (ARR).
• Confirmatory oral salt load testing (OSLT) for patients with a positive ARR screen.
• Analysis of clinical characteristics associated with confirmed PA.

Main Results:

• The overall prevalence of PA was 0.7% (2 out of 296 patients).
• Patients with confirmed PA were more likely to have resistant hypertension (42.9%) and require more antihypertensive agents (2.8 vs. 2.1).
• A trend towards lower potassium values was observed in patients with PA.

Conclusions:

• The prevalence of PA in this primary care setting is lower than in specialized "at-risk" populations.
• Screening for PA is indicated in patients with resistant hypertension, even without hypokalemia.
• These findings support targeted screening for PA in primary care.