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Who needs to be screened for primary aldosteronism?
Huang, Wei-Chieh; Liu, Feng-Hsuan; Cheng, Hao-Min; Tsai, Yi-Chun; Huang, Yen-Ta; Lai, Tai-Shuan; Lin, Yen-Hung; Wu, Vin-Cent; Kao, Hsien-Li; Jia-Yin Hou, Charles; Wu, Kwan-Dun; Chen, Szu-Tah; Er, Leay Kiaw.
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  • Huang WC; Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan.
  • Liu FH; Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Cheng HM; Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taiwan.
  • Tsai YC; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical, Taiwan; University Hospital, Kaohsiung University Hospital, Kaohsiung, Taiwan.
  • Huang YT; Department of Surgery, National Cheng Kung University Hospital, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Lai TS; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, Taiwan.
  • Lin YH; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
  • Wu VC; Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, Taiwan.
  • Kao HL; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
  • Jia-Yin Hou C; Cardiovascular Center, MacKay Memorial Hospital, Taipei, Taiwan.
  • Wu KD; Primary Aldosteronism Center at National Taiwan University Hospital, Taipei, Taiwan.
  • Chen ST; Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
  • Er LK; The Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; School of Medicine, Tzu-Chi University, Hualien, Taiwan. Electronic address: leay29010@gmail.com.
J Formos Med Assoc ; 123 Suppl 2: S82-S90, 2024 Mar.
Article en En | MEDLINE | ID: mdl-37633770
The prevalence of patients with primary aldosteronism (PA) is about 5%-15% in hypertensive patients, and it is common cause of secondary hypertension in clinical practice. Two major causes of PA are noted, namely bilateral adrenal hyperplasia and aldosterone-producing adenoma, and the general diagnosis is based on three steps: (1) screening, (2) confirmatory testing, and (3) subtype differentiation (Figure 1). The recommendation for screening patients is at an increased risk of PA, here we focus on which patients should be screened for PA, not only according to well-established guidelines but for potential patients with PA. We recommend screening for 1) patients with resistant or persistent hypertension, 2) hypertensive patients with hypokalemia (spontaneous or drug-induced), 3) young hypertensive patients (age <40 years), and 4) all hypertensive patients with a history of PA in first-degree relatives. Moreover, we suggest screening for 1) hypertensive patients themselves or first-degree relatives with early target organ damage, such as stroke and other diseases, 2) all hypertensive patients with a concurrent adrenal incidentaloma, 3) hypertensive patients with obstructive sleep apnea, 4) hypertensive patients with atrial fibrillation unexplained by structural heart defects and/or other conditions resulting in the arrhythmia, 5) hypertensive patients with anxiety and other psychosomatic symptoms, and 6) hypertensive patients without other comorbidities to maintain cost-effectiveness.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de las Glándulas Suprarrenales / Hiperaldosteronismo / Hipertensión Tipo de estudio: Guideline / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Formos Med Assoc Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Singapur
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de las Glándulas Suprarrenales / Hiperaldosteronismo / Hipertensión Tipo de estudio: Guideline / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Formos Med Assoc Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Singapur