Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and The Department of Endocrinology, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden.
Department of Internal Medicine, Northern Älvsborg County Hospital, SE-461 85, Trollhättan, Sweden.
J Clin Endocrinol Metab. 2021 Aug 18;106(9):e3603-e3610. doi: 10.1210/clinem/dgab327.
Primary aldosteronism (PA) is the most common cause of secondary hypertension. Yet, the incidence of PA in the general population has not been studied.
To estimate the incidence of PA in the general population.
Patients who had received a diagnostic code for PA between 1987 and 2016 were identified in the Swedish National Patient Registry. Assessment of clinical and biochemical data was used to validate the diagnosis. The annual incidence of PA was calculated by using the number of inhabitants in the Västra Götaland County as a reference.
Of 570 identified patients, 473 (83%) had confirmed PA. Eligible for the incidence analysis were 416 patients, 248 (60%) men and 168 (40%) women, diagnosed with PA between 1987 and 2016. The mean (± standard deviation) age at diagnosis was 56 ± 12 years. The median (interquartile range) annual incidence was 2 (1-2) cases per million between 1987 and 1996, 6 (4-9) cases per million between 1997 and 2006 and 17 (12-24) cases per million between 2007 and 2016. At the end of the study (December 31, 2016), 386 patients with confirmed PA were alive and living in the Västra Götaland County, giving a prevalence of 231 cases per million (0.022%).
Despite increasing incidence, the proportion of patients identified with PA is lower than expected. Given the serious consequences of untreated PA, the noticeably low prevalence at the end of the study stresses the need to increase the awareness of PA among health care providers.
原发性醛固酮增多症（PA）是继发性高血压的最常见病因。然而，一般人群中 PA 的发病率尚未得到研究。
估计一般人群中 PA 的发病率。
在瑞典国家患者登记处确定了 1987 年至 2016 年期间接受过 PA 诊断代码的患者。使用临床和生化数据评估来验证诊断。PA 的年发病率通过使用西约塔兰县的居民人数作为参考来计算。
在确定的 570 例患者中，有 473 例（83%）被确认为 PA。有资格进行发病率分析的是 416 例患者，其中 248 例（60%）为男性，168 例（40%）为女性，他们在 1987 年至 2016 年间被诊断为 PA。诊断时的平均（±标准差）年龄为 56±12 岁。1987 年至 1996 年期间，每年每百万人中有 2（1-2）例，1997 年至 2006 年期间每年每百万人中有 6（4-9）例，2007 年至 2016 年期间每年每百万人中有 17（12-24）例。在研究结束时（2016 年 12 月 31 日），386 例确诊为 PA 的患者仍在世并居住在西约塔兰县，患病率为每百万人 231 例（0.022%）。
尽管发病率不断上升，但确定的 PA 患者比例低于预期。鉴于未经治疗的 PA 会带来严重后果，研究结束时明显较低的患病率强调了提高医疗保健提供者对 PA 的认识的必要性。
