Primary Aldosteronism and Cardiovascular Events
It Is Time to Take Guideline Recommendations Seriously
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See related article, pp 530–537
It is nowadays widely accepted that primary aldosteronism is the most frequent cause of endocrine hypertension. Prevalence rates among patients with hypertension are 6% in the primary care setting and 11% in tertiary care referral centers.1 The 2016 Endocrine Society Practice Guidelines2 recommend screening of hypertensive subjects with increased pretest probability, which accounts to roughly 50% of all hypertensives. Nevertheless, these recommendations stand isolated and are not fully reflected by current hypertension guidelines in the United States or Europe. More importantly, current healthcare data suggest that little has changed in terms of screening: according to a 2015 survey, only 1% of hypertensives are screened in Italy and 2% in Germany by general practitioners.3 It is in this context in the current issue of the journal that Ohno et al4 publish their data from the recently founded Japan Primary Aldosteronism Study.
Using the large data set of 2582 patients with primary aldosteronism, the authors analyzed clinical and biochemical factors associated with prevalent cardiovascular disease. The patients were treated in 15 university hospitals and 14 city hospitals …