Are We Only Detecting the Tip of the Iceberg? A Nationwide Study on Primary Aldosteronism with up to 8-Year Follow-up
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Updated: Sep 25, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Hrafnhildur Gunnarsdottir1,2, Gudbjorg Jonsdottir1, Gudjon Birgisson3
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Background:
Long-term follow-up studies on primary aldosteronism (PA) are lacking.
Objective:
We aim to review results of diagnostic procedures and histopathology for patients diagnosed during 2012-2016 in Iceland, compare unilateral (UD) and bilateral disease (BD) and assess treatment response.
Methods:
Thirty-two patients aged 28-88 were diagnosed and treated according to guidelines.
Results:
The majority had BD. Everyone needed potassium supplementation at case detection. We saw a reduction in systolic blood pressure (p < .001, both groups), antihypertensive agents (p = .002 UD and p = .04 BD) and potassium supplementation (p < .001, both groups).
Conclusion:
Similar treatment response was seen in both subgroups. Ratio of hypokalemia and number of cases indicates severe PA underdiagnosis in Iceland.
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