Primary aldosteronism: Screening, diagnosis, and management

Area of Science:

• Endocrinology
• Nephrology
• Primary Care Medicine

Background:

• Hypertension (HTN) is a prevalent condition managed by physician associates (PAs).
• Approximately 10% of HTN cases are secondary, with primary aldosteronism being a leading cause.
• Primary aldosteronism involves excess aldosterone production by adrenal glands, leading to sodium and water retention and contributing to HTN.

Purpose of the Study:

• To raise PA awareness of primary aldosteronism indicators for screening.
• To review primary aldosteronism screening and treatment in primary care settings.
• To guide appropriate specialist referrals for primary aldosteronism management.

Main Methods:

• Literature review on primary aldosteronism.
• Analysis of diagnostic indicators for screening in primary care.
• Discussion of treatment strategies and referral pathways.

Main Results:

• Primary aldosteronism is underdiagnosed due to nonspecific symptoms.
• Untreated primary aldosteronism increases risks of cardiovascular disease, CKD, and metabolic syndrome.
• PAs play a crucial role in identifying patients who require screening.

Conclusions:

• Enhanced awareness and screening for primary aldosteronism are essential in primary care.
• Timely diagnosis and management can mitigate severe health consequences.
• Clear referral guidelines are necessary for effective specialist collaboration.