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Cited by 1,467Hormonal Regulation and HypertensionAdrenal and Paraganglionic TumorsRenin-Angiotensin System Studies

A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients

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Rossi, Gian Paolo, Bernini, Giampaolo, Caliumi, Chiara, Desideri, Giovambattista, Fabris, Bruno, Ferri, Claudio, Ganzaroli, Chiara, Giacchetti, Gilberta +15 more·2006·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2006.07.059
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Abstract

Objectives We prospectively investigated the prevalence of curable forms of primary aldosteronism (PA) in newly diagnosed hypertensive patients.Background The prevalence of curable forms of PA is currently unknown, although retrospective data suggest that it is not as low as commonly perceived.Methods Consecutive hypertensive patients referred to 14 hypertension centers underwent a diagnostic protocol composed of measurement of Na+ and K+ in serum and 24-h urine, sitting plasma renin activity, and aldosterone at baseline and after 50 mg captopril. The patients with an aldosterone/renin ratio >40 at baseline, and/or >30 after captopril, and/or a probability of PA (by a logistic discriminant function) > or =50% underwent imaging tests and adrenal vein sampling (AVS) or adrenocortical scintigraphy to identify the underlying adrenal pathology. An aldosterone-producing adenoma (APA) was diagnosed in patients who in addition to excess autonomous aldosterone secretion showed: 1) lateralized aldosterone secretion at AVS or adrenocortical scintigraphy, 2) adenoma at surgery and pathology, and 3) a blood pressure decrease after adrenalectomy. Evidence of excess autonomous aldosterone secretion without such criteria led to a diagnosis of idiopathic hyperaldosteronism (IHA).Results A total of 1,180 patients (age 46 +/- 12 years) were enrolled; a conclusive diagnosis was attained in 1,125 (95.3%). Of these, 54 (4.8%) had an APA and 72 (6.4%) had an IHA. There were more APA (62.5%) and fewer IHA cases (37.5%) at centers where AVS was available (p = 0.002); the opposite occurred where AVS was unavailable.Conclusions In newly diagnosed hypertensive patients referred to hypertension centers, the prevalence of APA is high (4.8%). The availability of AVS is essential for an accurate identification of the adrenocortical pathologies underlying PA.

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  • Only 9% to 37% of patients with primary hyperaldosteronism were hypokalemic in a recent multicenter analysis.

    “A recent multicenter analysis estimated that only 9% to 37% of patients with primary hyperaldosteronism were hypokalemic (276,277).”

    From Adrenal incidentaloma (2020) · cites this paper as [277]

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  1. [20]20. Rossi GP, Bernini G, Desideri G, et al. Renal damage in primary aldosteronism. Hypertension 2006;48:232-8.

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Authors
Rossi, G. P., Bernini, G., Caliumi, C., Desideri, G., Fabris, B., Ferri, C., Ganzaroli, C., Giacchetti, G., Letizia, C., Maccario, M., Mallamaci, F., Mannelli, M., Mattarello, M.-J., Moretti, A., Palumbo, G., Parenti, G., Porteri, E., Semplicini, A., Rizzoni, D., Rossi, E., Boscaro, M., Pessina, A. C., & Mantero, F.
Corresponding author
Rossi, Gian Paolo
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2006-12
Volume
48
Issue
11
Pages
2293-2300
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2006.07.059
OpenAlex
W2107999636
Cited by
1,467
References
54
Citations by year
2026: 54 · 2025: 82 · 2024: 69 · 2023: 81 · 2022: 94 · 2021: 77 · 2020: 97 · 2019: 101 · 2018: 94 · 2017: 101 · 2016: 87 · 2015: 91 · 2014: 73 · 2013: 66 · 2012: 66
FWCI
26.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Padua Research Archive (University of Padova) (submittedVersion, other-oa)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion)
  • Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
  • Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
  • Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords
primary aldosteronism, aldosterone-producing adenoma, idiopathic hyperaldosteronism, hypertension, prevalence, adrenal vein sampling, aldosterone-renin ratio, adrenalectomy
MeSH terms
Adrenal Cortex Neoplasms, Adrenal Glands, Adult, Aldosterone, Blood Specimen Collection, Female, Humans, Hyperaldosteronism, Hypertension, Male, Middle Aged, Prospective Studies, Radionuclide Imaging, Veins, Prevalence, Adrenocortical Adenoma

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