CC BY-NC-ND 4.0 · Horm Metab Res 2020; 52(06): 345-346
DOI: 10.1055/a-1156-9926
Editorial

Progress in Primary Aldosteronism 2019: New Players on the Block?

Martin Reincke
Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
,
Felix Beuschlein
Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
,
Tracy Ann Williams
Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
› Author Affiliations
Funding: Additional grant support of the authors of this editorial are: the Else Kröner-Fresenius Stiftung (2013_A182, 2015_A171 and 2019_ A104 to MR) to M.R., the Deutsche Forschungsgemeinschaft to F.B. (BE2177/13-1), and to the European Research Council (grant number 694913 [PAPA] to M.R.).

Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated aldosterone to renin ratio. It is nowadays the universally accepted main cause of endocrine hypertension. According to the most recent epidemiological data, PA is present in 5.8% of unselected hypertensives in primary care, 6–12% of hypertensives treated in hypertension centers, and up to 30% in subjects with resistant hypertension [1]. Despite this high prevalence, a recent survey demonstrated that screening for PA is not universally followed. Renin and aldosterone measurements, the basis for PA screening, are currently performed by only 7% of general practitioners in Italy and 8% in Germany [2]. Accordingly, the prevalence of PA was low with 1% among hypertensives in Italy and 2% in Germany. In a retrospective cohort study of 4660 patients with resistant hypertension in California the screening rate for PA was 2.1% [3]. Based on these data, it is clear that we still miss the majority of PA cases, despite advances in diagnosis and therapy.



Publication History

Received: 07 April 2020

Accepted: 08 April 2020

Article published online:
16 June 2020

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