Screening Rate for Primary Aldosteronism Among Patients With Apparent Treatment Resistant Hypertension: Retrospective Analysis of Current Practice


Primary aldosteronism (PA) is the most common secondary cause of hypertension. Patients with PA experience significant cardiovascular and other complications compared to patients with primary hypertension for the same degree of blood pressure control. Guidelines recommend screening all patients with resistant hypertension for PA. The objective of this study was to assess screening rate for PA among patients with apparent treatment resistant hypertension and to determine the rate of positive screening test result among the group screened. This is a retrospective chart review of electronic medical record data of all patients with hypertension and >18 years within a single health system in Minnesota from September 2018 – September 2020. Out of 140,734 patients who were>18 years with a diagnosis of hypertension, 13.4% (18,908) fulfilled the criteria for apparent treatment resistant hypertension after excluding those with congestive heart failure. Only 4.2% (795) of patients with apparent treatment resistant hypertension had screening for PA in our cohort. Of the 795 patients who had screening for PA, 16.9% (134) had a positive screening test result. The screening rate for PA among patients with resistant hypertension is low. Clinical and public health strategies directed at improving screening rate for PA are vital.

Authors: Kidmeaelm Zekarias, Katelyn M. Tessier
Keywords: screening, resistant hypertension
DOI Number: 10.1016/j.eprac.2021.11.085      Publication Year: 2021

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