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Primary aldosteronism in the primary care setting.

Fabrizio Buffolo1, Silvia Monticone, Martina Tetti

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Primary aldosteronism is more common than previously thought, even in mild hypertension cases. Early screening is crucial to reduce cardiovascular risks associated with this underdiagnosed condition.

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Area of Science:

  • Endocrinology
  • Hypertension Research
  • Clinical Medicine

Background:

  • Primary aldosteronism (PA) was historically associated with severe hypertension and hypokalemia.
  • Recent research indicates PA is prevalent in mild hypertension and normokalemic patients.
  • Subclinical PA in normotensive individuals is a significant risk factor for developing hypertension.

Purpose of the Study:

  • To review current studies on primary aldosteronism prevalence in primary care.
  • To compare diagnosed rates with actual prevalence in general and specific patient groups.
  • To highlight the underdiagnosis and undertreatment of primary aldosteronism.

Main Methods:

  • Systematic review of updated studies on primary aldosteronism prevalence.
  • Comparative analysis of diagnostic rates versus actual prevalence.
  • Examination of PA prevalence in specific patient subgroups.

Main Results:

  • Primary aldosteronism is increasingly recognized across a broader spectrum of hypertensive patients.
  • A significant number of normotensive individuals may have subclinical PA.
  • PA patients face higher risks of cardiovascular events and metabolic issues than essential hypertension patients.

Conclusions:

  • Primary aldosteronism is underdiagnosed and undertreated, despite its prevalence and associated risks.
  • Screening for PA should be expanded to a wider patient population.
  • Early detection and treatment of PA can mitigate associated cardiovascular risks.