Implementation of a Spanish-language, direct-to-patient primary aldosteronism testing program

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Health Disparities

Background:

• Primary aldosteronism (PA) is a significant, treatable cause of hypertension and cardiovascular disease.
• PA testing rates are low (<2%), with underrepresentation of Hispanic/Latino populations in research and clinical care.
• Addressing these disparities is crucial for managing hypertension in diverse populations.

Purpose of the Study:

• To expand a nationwide, direct-to-patient program for primary aldosteronism (PA) testing to Spanish-speaking adults.
• To improve access to diagnosis and care for hypertension in an underserved population.
• To evaluate the effectiveness of language-concordant outreach for PA screening.

Main Methods:

• Recruited Spanish-speaking adults with PA indications across five major US cities.
• Conducted virtual medical history reviews and local phlebotomy for PA testing in Spanish.
• Communicated results to patients and clinicians, with 6-month follow-up to assess outcomes.

Main Results:

• 155 participants completed the study, with 77.4% reporting limited English proficiency.
• 30.3% of participants tested positive for primary aldosteronism (PA).
• Among those positive for PA, 10.3% initiated aldosterone-targeted therapy, with barriers including access to care.

Conclusions:

• A Spanish-language, direct-to-patient PA testing program effectively reached and tested patients.
• The program identified PA in over 30% of participants and influenced downstream clinical actions.
• Language-concordant initiatives are vital for addressing hypertension and PA prevalence in U.S. Hispanic/Latino populations.