Testing for Primary Aldosteronism and Mineralocorticoid Receptor Antagonist Use Among U.S. Veterans


Primary aldosteronism is a common cause of treatment-resistant hypertension. However, evidence from local health systems suggests low rates of testing for primary aldosteronism. The objective of this retrospective cohort study was to evaluate testing rates for primary aldosteronism and evidence-based hypertension management. In a nationally distributed cohort of veterans with apparent treatment-resistant hypertension, testing for primary aldosteronism was rare and was associated with higher rates of evidence-based treatment with MRAs and better longitudinal BP control. The findings reinforce prior observations of low adherence to guideline-recommended practices in smaller health systems and underscore the urgent need for improved management of patients with treatment-resistant hypertension.

Authors: Jordana B. Cohen, Debbie L. Cohen, Daniel S. Herman, John T. Leppert, James Brian Byrd, Vivek Bhalla
Keywords: screening, diagnosis, testing rate
DOI Number: 10.7326/M20-4873      Publication Year: 2021

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