Universidade Federal Fluminense, Departamento de Clínica Médica, Hospital Universitário Antônio Pedro, Niterói, RJ, Brasil,
Disciplina de Clínica Médica, Universidade Estácio de Sá/ IDOMED, Rio de Janeiro, RJ, Brasil.
Arch Endocrinol Metab. 2024 Mar 15;68:e230211. doi: 10.20945/2359-4292-2023-0211.
Despite its recognized importance, primary hyperaldosteronism (PHA) remains an underdiagnosed condition in clinical practice. The objective of the present study was to evaluate PHA screening practices by general practitioners and specialists in endocrinology and cardiology.
This cross-sectional, observational study invited physicians to respond voluntarily to an online survey. The survey collected the respondents' sociodemographic data and answers to five hypothetical clinical cases meeting Endocrine Society criteria for PHA screening.
In all, 126 physicians responded to the online survey. Endocrinologists were the specialists who most often chose PHA screening, although the screening rates were overall low, ranging from 36.5% to 92.9%, depending on the case and the respondents' specialty. The survey also assessed the reasons for not choosing PHA screening, which included limited availability of tests within the public health services, interference of antihypertensive medications on hormone levels, and failure to identify the screening indication. Being an endocrinologist was an independent predictor for choosing PHA screening for the patients in Cases #1 and #5 (p = 0.001 and p = 0.002, respectively).
Endocrinologists were the specialists who most often chose PHA screening, although the screening rates were overall low among all specialists. These findings highlight a need for continuing medical education programs addressing PHA screening and making the diagnosis of PHA more present in the daily clinical practice of physicians treating patients with hypertension.
尽管原发性醛固酮增多症（PHA）已被公认具有重要性，但在临床实践中，这种疾病仍未得到充分诊断。本研究旨在评估初级保健医生和内分泌科及心内科专家对 PHA 的筛查实践。
这是一项横断面、观察性研究，邀请医生自愿对在线调查做出回应。该调查收集了应答者的社会人口统计学数据以及对 5 个符合内分泌学会 PHA 筛查标准的假设临床病例的回答。
共有 126 名医生回复了在线调查。内分泌科医生是最常选择 PHA 筛查的专家，尽管总体筛查率较低，从 36.5%到 92.9%不等，具体取决于病例和应答者的专业。该调查还评估了未选择 PHA 筛查的原因，包括公共卫生服务中检测方法的有限可用性、降压药物对激素水平的干扰以及未能确定筛查指征。作为内分泌科医生是选择对病例 #1 和病例 #5 进行 PHA 筛查的独立预测因素（p = 0.001 和 p = 0.002）。
内分泌科医生是最常选择 PHA 筛查的专家，尽管所有专家的总体筛查率都较低。这些发现强调了需要开展继续医学教育项目，以解决 PHA 筛查问题，并使 PHA 的诊断在治疗高血压患者的医生日常临床实践中更为常见。
