Study: Many Patients At Risk for Common High Blood Pressure Disorder Do Not Receive Screening

Just 3% of patients at high risk for primary aldosteronism (PA) receive screening for the condition, according a new study presented at the Endocrine Society’s annual meeting.

PA is a common disorder that causes high blood pressure and can lead to heart and kidney complications, according to the study authors. It is the most common form of secondary hypertension and occurs when the adrenal glands produce too much aldosterone, the hormone that balances potassium and sodium in the body. Overproduction of aldosterone causes the body to retain more sodium and lose potassium, leading to elevated blood pressure.

Patients with PA have a higher risk of developing cardiovascular and kidney complications compared with patients with primary hypertension with similar blood pressure, according to the study.

The investigators reviewed data for adult patients with hypertension seen in outpatient clinics between 2010 and 2019 who were known to be at risk for PA. Of 11,627 patients, only 3% were ever screened for PA. Risk factors included hypertension resistant to treatment, hypertension below age 40, hypertension and obstructive sleep apnea, hypertension and potassium deficiency, and hypertension and a mass in the adrenal gland.

According to the press release, patients who were screened generally were younger, and Black patients were more likely to be screened than patients of other races. Lead researcher Seda Grigoryan, MD, said in the press release that the diagnosis of PA was suspected more often after other complications had already developed, such as strokes and kidney disease. Of the patients at high risk for PA, screening was done more often in patients with adrenal nodules (35%) and least often in those with sleep apnea (2%).

“The results of our study indicate that initiatives to encourage PA screening are crucial for preventing cardiovascular and kidney disease in many patients with hypertension,” Grigoryan said in the press release.

REFERENCE

Few patients at risk for common high blood pressure disorder receive screening [news release]. Endocrine Society; March 20, 2021. https://www.endocrine.org/news-and-advocacy/news-room/featured-science-from-endo-2021/few-patients-at-risk-for-common-high-blood-pressure-disorder-receive-screening. Accessed March 30, 2021.