High Prevalence and a Long Delay in the Diagnosis of Primary Aldosteronism Among Patients With Young-onset Hypertension


Despite being the most common cause of secondary hypertension, prevalence of primary aldosteronism (PA) among patients with young-onset hypertension (YH – age of hypertension onset <40 years) remains poorly studied. In this prospective, cross-sectional study, 202 patients with YH, visiting endocrine and cardiology clinics of All India Institute of Medical Sciences, India, were evaluated. Of 202 YH patients, 38 (18.8%) screened positive, and PA was confirmed in 36 (17.8%). The mean age was 43.9 ± 10.9 years, and median duration of hypertension was 10.5 (3.5-18) years. The prevalence of PA increased with grade of hypertension (8.1% in grade 1 to 37.1% in grade 3), number of antihypertensive medications (2.5% in those taking ≤1 to 50% in those taking ≥4 medications) and severity of hypokalaemia (0% in potassium >5 to 85.7% in potassium <3.5 mmol/L). The prevalence of PA by age of hypertension onset was highest in age group 30-39 years (31.3%). There is a high prevalence and a long delay in diagnosis of PA among patients with YH, and YH should be considered as a separate high-risk category in PA screening algorithm.

Authors: Sarah Alam, Devasenathipathy Kandasamy, Alpesh Goyal, Sreenivas Vishnubhatla, Sandeep Singh, Ganesan Karthikeyan, Rajesh Khadgawat
Keywords: hypokalaemic periodic paralysis, prevalence, primary aldosteronism, resistant hypertension, young-onset hypertension
DOI Number: 10.1111/cen.14409      Publication Year: 2021

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