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A Novel Method: Super-selective Adrenal Venous Sampling
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Primary aldosteronism in a general population sample. The Czech post-MONICA study.
Jiří Widimský1, Jan Bruthans2, Peter Wohlfahrt2
1Department of Medicine III, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Blood Pressure
|February 11, 2020
Summary
The study found that while 8% of hypertensive individuals in a general population sample had a high aldosterone/renin ratio, only 2% were confirmed to have primary aldosteronism (PA). This highlights challenges in accurately determining PA prevalence due to participant cooperation.
Area of Science:
- Endocrinology
- Cardiology
- Epidemiology
Background:
- Primary aldosteronism (PA) is the most common cause of secondary hypertension.
- Its prevalence in the general population remains uncertain and debated.
Purpose of the Study:
- To determine the prevalence of primary aldosteronism in a randomly selected general population sample.
- To investigate the diagnostic challenges in epidemiological studies of PA.
Main Methods:
- Screened 1940 individuals (aged 25-64) for cardiovascular risk factors.
- Assessed 740 hypertensive individuals for PA using plasma renin and serum aldosterone levels.
- Confirmed PA diagnosis with saline infusion tests.
Main Results:
- A high aldosterone/renin ratio (ARR) was observed in 8% (52/645) of hypertensive participants.
- The diagnosis of PA was confirmed in only 2% (13/645) of these individuals.
- Low participant compliance for further work-up (27%) impacted definitive diagnosis.
Conclusions:
- The confirmed prevalence of PA in this general population sample was 2%.
- Epidemiological studies on PA face significant challenges due to variable participant engagement.
- Accurate PA prevalence assessment requires high participant cooperation for confirmatory testing.
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