Screening for Adrenal-Endocrine Hypertension: Overview of Accuracy and Cost-effectiveness
Open accessAbstract
Formal studies have not been performed to assess the cost-effectiveness of screening strategies for endocrine causes of hypertension. However, an understanding of the diagnostic accuracy of available screening tests and the clinical settings where disease identification will lead to improved health outcomes form the basis for a cost-effective strategy. Primary aldosteronism screening should be selective and restricted to settings where knowledge of the diagnosis has the greatest chance of improving health outcomes. Pheochromocytoma is rare; however, because it is a potentially fatal disease, screening strategies should err on the side of not missing the diagnosis, especially in high-risk clinical settings.
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Catechol O-methyl transferase releases normetanephrine and metanephrine from pheochromocytoma/paraganglioma tumors, measured as plasma free metanephrines with sensitivity 96%-100% and specificity 89%-98%, or urinary fractionated metanephrines with sensitivity 86%-97% and specificity 86%-95%.
“Catechol 0-methyl transferase releases normetanephrine and metanephrine from the tumors, measured as plasma free (sensitivity, 96%−100%; specificity, 89%−98%) or urinary fractionated (sensitivity, 86%−97%; specificity, 86%−95%) metanephrines.321”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [321]
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- Authors
- Schwartz, G. L.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Schwartz, Gary L.
- ORCID
- Schwartz, Gary L.
- Venue
- Endocrinology and Metabolism Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 40
- Issue
- 2
- Pages
- 279-294
- ISSN
- 0889-8529 (ISSN-L)
- PMC
- PMC3094544
- OpenAlex
- W2049262968
- Cited by
- 36
- References
- 53
- Citations by year
- 2024: 3 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 5
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Endocrinology and Metabolism Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000454)
- National Heart, Lung, and Blood Institute (R01HL053330)
- National Center for Research Resources (M01RR000585, M01RR000039)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- hypertension screening, primary aldosteronism, pheochromocytoma, diagnostic accuracy, cost-effectiveness, targeted screening
- MeSH terms
- Adrenal Gland Diseases, Adrenal Gland Neoplasms, Adult, Child, Cost-Benefit Analysis, Humans, Hyperaldosteronism, Hypertension, Mass Screening, Pheochromocytoma, Sensitivity and Specificity, Prevalence
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