Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents

Paolo Mulatero, Michael Stowasser, Keh Chuan Loh, Carlos E. Fardella, Richard D. Gordon, Lorena Mosso, Celso E. Gomez-Sanchez, Franco Veglio, William F. Young

Research output: Contribution to journalArticlepeer-review

707 Scopus citations


Primary aldosteronism (PA) is a common form of endocrine hypertension previously believed to account for less than 1% of hypertensive patients. Hypokalemia was considered a prerequisite for pursuing diagnostic tests for PA. Recent studies applying the plasma aldosterone/plasma renin activity ratio (ARR) as a screening test have reported a higher prevalence. This study is a retrospective evaluation of the diagnosis of PA from clinical centers in five continents before and after the widespread use of the ARR as a screening test. The application of this strategy to a greater number of hypertensives led to a 5- to 15-fold increase in the identification of patients affected by PA. Only a small proportion of patients (between 9 and 37%) were hypokalemic. The annual detection rate of aldosterone-producing adenoma (APA) increased in all centers (by 1.3-6.3 times) after the wide application of ARR. Aldosterone-producing adenomas constituted a much higher proportion of patients with PA in the four centers that employed adrenal venous sampling (28-50%) than in the center that did not (9%). In conclusion, the wide use of the ARR as a screening test in hypertensive patients led to a marked increase in the detection rate of PA.

Original languageEnglish (US)
Pages (from-to)1045-1050
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
StatePublished - Mar 2004

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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