Abstract:
:Primary aldosteronism (PA) is the most common endocrine cause of resistant hypertension. Individuals with PA are at increased cardiovascular risk, and an appropriate management and treatment would ideally reduce such risk. Screening and diagnosis of PA requires a specific diagnostic test which is considered time- and cost-consuming and, as a result, is underperformed in clinical practice. An online survey reviewing available diagnostic procedures, laboratory testing, and clinical protocols for screening and confirmation of PA diagnosis was conducted among clinical lead of Reference and Excellence centers of the Italian Hypertension Society. A total of 102 questionnaires were sent and 62 centers participated in the survey. Assessment of the plasma renin (plasma renin activity/direct renin concentration) and plasma aldosterone concentration (PAC) was available in all centers. Captopril challenge test (CCT) and saline infusion test (SIT) were available in 60% and 61% of the centers, respectively. Fludrocortisone suppression test was available in 32% of the units. Adrenal vein sampling was accessible in 32% of the centers. We found discrepancies in cutoff levels of aldosterone-to-renin ratio (ARR) and PAC after SIT. Other discrepancies involved the duration of the wash-out period before ARR testing and dosage of captopril administered during CCT. In conclusion, although all centers are sufficiently equipped to perform PA screening, often patients should be referred to other centers to confirm the diagnosis of PA. A greater uniformity across centers to define precise cutoffs for screening and confirmatory testing for the diagnosis of PA would be of utility.
journal_name
J Hum Hypertensjournal_title
Journal of human hypertensionauthors
Pucci G,Monticone S,Agabiti Rosei C,Balbi G,Bertacchini F,Ragazzo F,Saladini F,Pengo MF,Young Investigator Group of the Italian Hypertension Society (Società Italiana dell’Ipertensione Arteriosa).doi
10.1038/s41371-018-0094-6subject
Has Abstractpub_date
2018-11-01 00:00:00pages
745-751issue
11eissn
0950-9240issn
1476-5527pii
10.1038/s41371-018-0094-6journal_volume
32pub_type
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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abstract::It has been shown in animal experiments that angiotensin II and aldosterone have mitogenic effects on the cardiovascular system, whereas atrial natriuretic peptide has antimitogenic properties. The aim of the present study was to relate plasma renin activity, angiotensin II, aldosterone and atrial natriuretic peptide ...
journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
doi:
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2001-07-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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journal_title:Journal of human hypertension
pub_type: 临床试验,杂志文章
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更新日期:1988-10-01 00:00:00
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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更新日期:1994-11-01 00:00:00
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journal_title:Journal of human hypertension
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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journal_title:Journal of human hypertension
pub_type: 杂志文章,meta分析
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journal_title:Journal of human hypertension
pub_type: 杂志文章,评审
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章
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journal_title:Journal of human hypertension
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
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pub_type: 临床试验,杂志文章
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