Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Turin, Italy.
Curr Opin Endocrinol Diabetes Obes. 2018 Jun;25(3):155-159. doi: 10.1097/MED.0000000000000408.
The aim of the present manuscript is to provide an overview of the most updated studies on the prevalence of primary aldosteronism in primary care and to compare these figures with the actual rate of diagnosis in clinical practice and with the prevalence of primary aldosteronism in specific subgroup of patients.
Over the last 20 years the clinical spectrum of low renin hypertension and primary aldosteronism has changed dramatically. Once considered only in the presence of severe hypertension and hypokalemia, it is now well known that primary aldosteronism is not uncommon even in patients with mild forms of hypertension and/or normokalemia. Moreover, recent evidence points toward a large proportion of normotensive study participants as being affected by subclinical primary aldosteronism, which represents a strong risk factor for incident hypertension. Moreover, primary aldosteronism patients are exposed to an increased risk of cardio and cerebrovascular events and metabolic comorbidities compared with patients affected by essential hypertension. Disappointingly, primary aldosteronism remains a largely underdiagnosed and undertreated disorder.
These recent findings further highlight the importance of widening the spectrum of patients who should be screened for primary aldosteronism, to reduce the cardiovascular risk associated with this medical condition.
本综述旨在概述原发性醛固酮增多症在初级保健中的最新流行率研究，并将这些数据与临床实践中的实际诊断率和特定患者亚组中的原发性醛固酮增多症流行率进行比较。
在过去的 20 年中，低肾素型高血压和原发性醛固酮增多症的临床谱发生了巨大变化。曾经仅在严重高血压和低钾血症的情况下考虑，现在已经很清楚，即使在轻度高血压和/或血钾正常的患者中，原发性醛固酮增多症也并不少见。此外，最近的证据表明，很大一部分血压正常的研究参与者受到亚临床原发性醛固酮增多症的影响，这是高血压发病的一个强烈危险因素。此外，与原发性高血压患者相比，原发性醛固酮增多症患者发生心血管和脑血管事件以及代谢合并症的风险增加。令人失望的是，原发性醛固酮增多症仍然是一种严重诊断不足和治疗不足的疾病。
这些最近的发现进一步强调了扩大应筛查原发性醛固酮增多症的患者范围的重要性，以降低与这种疾病相关的心血管风险。
