Who needs to be screened for primary aldosteronism?

Wei Chieh Huang, Feng Hsuan Liu, Hao Min Cheng, Yi Chun Tsai, Yen Ta Huang, Tai Shuan Lai, Yen Hung Lin, Vin Cent Wu, Hsien Li Kao, Charles Jia-Yin Hou, Kwan Dun Wu, Szu Tah Chen, Leay Kiaw Er*

*此作品的通信作者

研究成果: Review article同行評審

1 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)S82-S90
期刊Journal of the Formosan Medical Association
123
DOIs
出版狀態Published - 3月 2024

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