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Current pattern of primary aldosteronism diagnosis: Delayed and complicated

BACKGROUND
Primary aldosteronism is the most common specifically treatable and potentially curable cause of hypertension.


OBJECTIVE
The aim of this study was to analyse the referral pattern and disease characteristics of patients with hypertension and suspected primary aldosteronism.


METHODS
We prospectively collected clinical data from patients who attended the Endocrine Hypertension Service (EHS) at Monash Health from May 2016 to May 2017.


RESULTS
Of 87 patients, 69.2% had indications for primary aldosteronism screening in the primary care setting, although only 3.7% were actually screened. At the time of referral to the EHS, 61% had hypertension for over 10 years and 42% of the patients with primary
aldosteronism had associated end-organ damage. Targeted treatment of primary aldosteronism led to biochemical and clinical improvement in all patients.


DISCUSSION
The diagnosis of primary aldosteronism is currently delayed and associated with significant end-organ damage. Increased awareness of primary aldosteronism and its screening indications in primary and tertiary care is needed for earlier diagnosis and improved outcomes.