High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension
Background Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young‐onset hypertension (YH ‐ age of hypertension onset 5 ng/dl underwent adrenal computed tomography (CT), followed by adrenal venous sampling (AVS). Results Of 20...
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| Veröffentlicht in: | Clinical endocrinology (Oxford) 2021-06, Vol.94 (6), p.895-903 |
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| creator | Alam, Sarah Kandasamy, Devasenathipathy Goyal, Alpesh Vishnubhatla, Sreenivas Singh, Sandeep Karthikeyan, Ganesan Khadgawat, Rajesh |
| description | Background
Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young‐onset hypertension (YH ‐ age of hypertension onset 5 ng/dl underwent adrenal computed tomography (CT), followed by adrenal venous sampling (AVS).
Results
Of 202 YH patients, 38 (18.8%) screened positive, and PA was confirmed in 36 (17.8%). The mean age was 43.9 ± 10.9 years, and median duration of hypertension was 10.5 (3.5–18) years. The prevalence of PA increased with grade of hypertension (8.1% in grade 1 to 37.1% in grade 3), number of antihypertensive medications (2.5% in those taking ≤1 to 50% in those taking ≥4 medications) and severity of hypokalaemia (0% in potassium >5 to 85.7% in potassium |
| doi_str_mv | 10.1111/cen.14409 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2475089117</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2527440590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-d9b7563e74f7e31a65e14f81c1dcc96eb1960304fe560b0946071d3340fc197b3</originalsourceid><addsrcrecordid>eNp10c1u1DAUBWALUdGhsOAFkCU2sEh7Hf-Nl2hUKFLVbsracpybGVeJPcRJq-x4BJ6RJ8FlBhZIeOPNd4_sewh5w-CclXPhMZ4zIcA8IyvGlazqWsnnZAUcoAKlxCl5mfM9AMg16BfklHNuOKv1iixXYbuj-xEfXI_RI3WxpY72KW5pi71baIh02iFtg9vGlEOmqSs-DG5cqOvblCccUwx5oG54mtq7KWCcMn0M044uaY7bn99_pJhxortlj-OEMYcUX5GTzvUZXx_vM_L10-Xd5qq6vv38ZfPxuvJcclO1ptFScdSi08iZUxKZ6NbMs9Z7o7BhRpV_ig6lggaMUKBZy7mAzjOjG35G3h9y92P6NmOe7BCyx753EdOcbS20hLVhTBf67h96n-YxltfZWta6bFgaKOrDQfkx5TxiZ4_rsAzsUx-29GF_91Hs22Pi3AzY_pV_Cijg4gAeQ4_L_5Ps5vLmEPkLpbGV0A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2527440590</pqid></control><display><type>article</type><title>High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension</title><source>Wiley Journals</source><creator>Alam, Sarah ; Kandasamy, Devasenathipathy ; Goyal, Alpesh ; Vishnubhatla, Sreenivas ; Singh, Sandeep ; Karthikeyan, Ganesan ; Khadgawat, Rajesh</creator><creatorcontrib>Alam, Sarah ; Kandasamy, Devasenathipathy ; Goyal, Alpesh ; Vishnubhatla, Sreenivas ; Singh, Sandeep ; Karthikeyan, Ganesan ; Khadgawat, Rajesh</creatorcontrib><description>Background
Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young‐onset hypertension (YH ‐ age of hypertension onset <40 years) remains poorly studied.
Objective
We assessed the prevalence of PA in patients with YH referred for evaluation of secondary hypertension.
Design and Patients
In this prospective, cross‐sectional study, 202 patients with YH, visiting endocrine and cardiology clinics of All India Institute of Medical Sciences, India, were evaluated.
Measurements
Primary aldosteronism was screened by measuring plasma aldosterone concentration (PAC) and direct renin concentration (DRC) and calculating aldosterone‐to‐renin ratio (ARR), followed by confirmatory saline infusion test (SIT) according to Endocrine Society Guideline. Those confirmed with post‐SIT PAC >5 ng/dl underwent adrenal computed tomography (CT), followed by adrenal venous sampling (AVS).
Results
Of 202 YH patients, 38 (18.8%) screened positive, and PA was confirmed in 36 (17.8%). The mean age was 43.9 ± 10.9 years, and median duration of hypertension was 10.5 (3.5–18) years. The prevalence of PA increased with grade of hypertension (8.1% in grade 1 to 37.1% in grade 3), number of antihypertensive medications (2.5% in those taking ≤1 to 50% in those taking ≥4 medications) and severity of hypokalaemia (0% in potassium >5 to 85.7% in potassium <3.5 mmol/L). The prevalence of PA by age of hypertension onset was highest in age group 30–39 years (31.3%).
Conclusions
There is a high prevalence and a long delay in diagnosis of PA among patients with YH, and YH should be considered as a separate high‐risk category in PA screening algorithm.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/cen.14409</identifier><identifier>PMID: 33393127</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Age ; Aldosterone ; Antihypertensives ; Computed tomography ; Diagnosis ; Endocrine disorders ; Hypertension ; hypokalaemic periodic paralysis ; Medical diagnosis ; Potassium ; prevalence ; primary aldosteronism ; Renin ; resistant hypertension ; young‐onset hypertension</subject><ispartof>Clinical endocrinology (Oxford), 2021-06, Vol.94 (6), p.895-903</ispartof><rights>2021 John Wiley & Sons Ltd</rights><rights>2021 John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-d9b7563e74f7e31a65e14f81c1dcc96eb1960304fe560b0946071d3340fc197b3</citedby><cites>FETCH-LOGICAL-c3539-d9b7563e74f7e31a65e14f81c1dcc96eb1960304fe560b0946071d3340fc197b3</cites><orcidid>0000-0002-8193-2779</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcen.14409$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcen.14409$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33393127$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alam, Sarah</creatorcontrib><creatorcontrib>Kandasamy, Devasenathipathy</creatorcontrib><creatorcontrib>Goyal, Alpesh</creatorcontrib><creatorcontrib>Vishnubhatla, Sreenivas</creatorcontrib><creatorcontrib>Singh, Sandeep</creatorcontrib><creatorcontrib>Karthikeyan, Ganesan</creatorcontrib><creatorcontrib>Khadgawat, Rajesh</creatorcontrib><title>High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Background
Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young‐onset hypertension (YH ‐ age of hypertension onset <40 years) remains poorly studied.
Objective
We assessed the prevalence of PA in patients with YH referred for evaluation of secondary hypertension.
Design and Patients
In this prospective, cross‐sectional study, 202 patients with YH, visiting endocrine and cardiology clinics of All India Institute of Medical Sciences, India, were evaluated.
Measurements
Primary aldosteronism was screened by measuring plasma aldosterone concentration (PAC) and direct renin concentration (DRC) and calculating aldosterone‐to‐renin ratio (ARR), followed by confirmatory saline infusion test (SIT) according to Endocrine Society Guideline. Those confirmed with post‐SIT PAC >5 ng/dl underwent adrenal computed tomography (CT), followed by adrenal venous sampling (AVS).
Results
Of 202 YH patients, 38 (18.8%) screened positive, and PA was confirmed in 36 (17.8%). The mean age was 43.9 ± 10.9 years, and median duration of hypertension was 10.5 (3.5–18) years. The prevalence of PA increased with grade of hypertension (8.1% in grade 1 to 37.1% in grade 3), number of antihypertensive medications (2.5% in those taking ≤1 to 50% in those taking ≥4 medications) and severity of hypokalaemia (0% in potassium >5 to 85.7% in potassium <3.5 mmol/L). The prevalence of PA by age of hypertension onset was highest in age group 30–39 years (31.3%).
Conclusions
There is a high prevalence and a long delay in diagnosis of PA among patients with YH, and YH should be considered as a separate high‐risk category in PA screening algorithm.</description><subject>Age</subject><subject>Aldosterone</subject><subject>Antihypertensives</subject><subject>Computed tomography</subject><subject>Diagnosis</subject><subject>Endocrine disorders</subject><subject>Hypertension</subject><subject>hypokalaemic periodic paralysis</subject><subject>Medical diagnosis</subject><subject>Potassium</subject><subject>prevalence</subject><subject>primary aldosteronism</subject><subject>Renin</subject><subject>resistant hypertension</subject><subject>young‐onset hypertension</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10c1u1DAUBWALUdGhsOAFkCU2sEh7Hf-Nl2hUKFLVbsracpybGVeJPcRJq-x4BJ6RJ8FlBhZIeOPNd4_sewh5w-CclXPhMZ4zIcA8IyvGlazqWsnnZAUcoAKlxCl5mfM9AMg16BfklHNuOKv1iixXYbuj-xEfXI_RI3WxpY72KW5pi71baIh02iFtg9vGlEOmqSs-DG5cqOvblCccUwx5oG54mtq7KWCcMn0M044uaY7bn99_pJhxortlj-OEMYcUX5GTzvUZXx_vM_L10-Xd5qq6vv38ZfPxuvJcclO1ptFScdSi08iZUxKZ6NbMs9Z7o7BhRpV_ig6lggaMUKBZy7mAzjOjG35G3h9y92P6NmOe7BCyx753EdOcbS20hLVhTBf67h96n-YxltfZWta6bFgaKOrDQfkx5TxiZ4_rsAzsUx-29GF_91Hs22Pi3AzY_pV_Cijg4gAeQ4_L_5Ps5vLmEPkLpbGV0A</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Alam, Sarah</creator><creator>Kandasamy, Devasenathipathy</creator><creator>Goyal, Alpesh</creator><creator>Vishnubhatla, Sreenivas</creator><creator>Singh, Sandeep</creator><creator>Karthikeyan, Ganesan</creator><creator>Khadgawat, Rajesh</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8193-2779</orcidid></search><sort><creationdate>202106</creationdate><title>High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension</title><author>Alam, Sarah ; Kandasamy, Devasenathipathy ; Goyal, Alpesh ; Vishnubhatla, Sreenivas ; Singh, Sandeep ; Karthikeyan, Ganesan ; Khadgawat, Rajesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-d9b7563e74f7e31a65e14f81c1dcc96eb1960304fe560b0946071d3340fc197b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Aldosterone</topic><topic>Antihypertensives</topic><topic>Computed tomography</topic><topic>Diagnosis</topic><topic>Endocrine disorders</topic><topic>Hypertension</topic><topic>hypokalaemic periodic paralysis</topic><topic>Medical diagnosis</topic><topic>Potassium</topic><topic>prevalence</topic><topic>primary aldosteronism</topic><topic>Renin</topic><topic>resistant hypertension</topic><topic>young‐onset hypertension</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alam, Sarah</creatorcontrib><creatorcontrib>Kandasamy, Devasenathipathy</creatorcontrib><creatorcontrib>Goyal, Alpesh</creatorcontrib><creatorcontrib>Vishnubhatla, Sreenivas</creatorcontrib><creatorcontrib>Singh, Sandeep</creatorcontrib><creatorcontrib>Karthikeyan, Ganesan</creatorcontrib><creatorcontrib>Khadgawat, Rajesh</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alam, Sarah</au><au>Kandasamy, Devasenathipathy</au><au>Goyal, Alpesh</au><au>Vishnubhatla, Sreenivas</au><au>Singh, Sandeep</au><au>Karthikeyan, Ganesan</au><au>Khadgawat, Rajesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2021-06</date><risdate>2021</risdate><volume>94</volume><issue>6</issue><spage>895</spage><epage>903</epage><pages>895-903</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><abstract>Background
Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young‐onset hypertension (YH ‐ age of hypertension onset <40 years) remains poorly studied.
Objective
We assessed the prevalence of PA in patients with YH referred for evaluation of secondary hypertension.
Design and Patients
In this prospective, cross‐sectional study, 202 patients with YH, visiting endocrine and cardiology clinics of All India Institute of Medical Sciences, India, were evaluated.
Measurements
Primary aldosteronism was screened by measuring plasma aldosterone concentration (PAC) and direct renin concentration (DRC) and calculating aldosterone‐to‐renin ratio (ARR), followed by confirmatory saline infusion test (SIT) according to Endocrine Society Guideline. Those confirmed with post‐SIT PAC >5 ng/dl underwent adrenal computed tomography (CT), followed by adrenal venous sampling (AVS).
Results
Of 202 YH patients, 38 (18.8%) screened positive, and PA was confirmed in 36 (17.8%). The mean age was 43.9 ± 10.9 years, and median duration of hypertension was 10.5 (3.5–18) years. The prevalence of PA increased with grade of hypertension (8.1% in grade 1 to 37.1% in grade 3), number of antihypertensive medications (2.5% in those taking ≤1 to 50% in those taking ≥4 medications) and severity of hypokalaemia (0% in potassium >5 to 85.7% in potassium <3.5 mmol/L). The prevalence of PA by age of hypertension onset was highest in age group 30–39 years (31.3%).
Conclusions
There is a high prevalence and a long delay in diagnosis of PA among patients with YH, and YH should be considered as a separate high‐risk category in PA screening algorithm.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33393127</pmid><doi>10.1111/cen.14409</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8193-2779</orcidid></addata></record> |
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| identifier | ISSN: 0300-0664 |
| ispartof | Clinical endocrinology (Oxford), 2021-06, Vol.94 (6), p.895-903 |
| issn | 0300-0664 1365-2265 |
| language | eng |
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| source | Wiley Journals |
| subjects | Age Aldosterone Antihypertensives Computed tomography Diagnosis Endocrine disorders Hypertension hypokalaemic periodic paralysis Medical diagnosis Potassium prevalence primary aldosteronism Renin resistant hypertension young‐onset hypertension |
| title | High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young‐onset hypertension |
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