Re: PA Diagnosis in 5 Continents

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You might want to refer to our publication weinberger and grim Et al 1980 which basically Said if u look for PA cArefuly u will find about 10%. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Increased Diagnosis of Primary Aldosteronism,

Including Surgically Correctable Forms, in Centers from Five Continents

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 theARRas 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 aldosteroneproducing adenoma (APA) increased in all centers (by 1.3–6.3 times) after the wide application of ARR. Aldosteroneproducing 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. (J Clin Endocrinol Metab 89: 1045–1050, 2004)

Deatils: http://jcem.endojournals.org/cgi/reprint/89/3/1045