{"id":7939,"date":"2025-07-16T15:35:39","date_gmt":"2025-07-16T12:35:39","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7939"},"modified":"2025-07-16T15:35:39","modified_gmt":"2025-07-16T12:35:39","slug":"all-individuals-with-hypertension-should-be-screened-for-primary-aldosteronism-pa","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/all-individuals-with-hypertension-should-be-screened-for-primary-aldosteronism-pa\/","title":{"rendered":"All individuals with hypertension should be screened for primary aldosteronism (PA)"},"content":{"rendered":"<div>All individuals with hypertension should be screened for primary aldosteronism (PA)<\/div>\n<div><\/div>\n<div>\ud83d\udd39 Key Summary: New Guidelines on Primary Aldosteronism (PA) Screening \u2013 July 2025<\/div>\n<div><span> 1. Universal PA Screening<\/span><\/div>\n<div>\u2013 All individuals with hypertension should be screened for primary aldosteronism (PA) using aldosterone and renin measurements.<\/div>\n<div>\u2013 The aldosterone-to-renin ratio (ARR) is the diagnostic cornerstone.<\/div>\n<div><span> 2. Importance of Screening<\/span><\/div>\n<div>\u2013 PA is a common, under-recognized cause of secondary hypertension.<\/div>\n<div>\u2013 Leads to sodium retention, volume overload, and organ damage.<\/div>\n<div><span> 3. High Cardiovascular Risk in PA<\/span><\/div>\n<div>\u2013 Compared to primary hypertension, PA is linked with:<\/div>\n<div>* 2\u00d7 risk of stroke<\/div>\n<div>* 3\u00d7 risk of atrial fibrillation<\/div>\n<div>* 2\u00d7 risk of kidney disease<\/div>\n<div>* Higher risk of coronary artery disease and heart failure<\/div>\n<div><span> 4. Prevalence Data<\/span><\/div>\n<div>\u2013 PA found in:<\/div>\n<div>* 5.9% of general hypertensives<\/div>\n<div>* 16.2% of young adults with HTN<\/div>\n<div>* 28.1% of those with hypokalemia<\/div>\n<div>* 42% with HTN + atrial fibrillation<\/div>\n<div>* 11.3\u201319.1% with HTN + type 2 diabetes<\/div>\n<div><span> 5. Preferred Treatment<\/span><\/div>\n<div>\u2013 MRAs (e.g., spironolactone) are first-line.<\/div>\n<div>\u2013 Surgery (unilateral adrenalectomy) for lateralized PA if patient is a surgical candidate.<\/div>\n<div><span> 6. Testing Enhancements<\/span><\/div>\n<div>\u2013 No need to stop all antihypertensive meds for screening in most cases.<\/div>\n<div>\u2013 Include potassium levels with ARR to avoid false negatives.<\/div>\n<div><span> 7. Imaging and Further Testing<\/span><\/div>\n<div>\u2013 If surgery is considered:<\/div>\n<div>* Do CT scan and adrenal venous sampling.<\/div>\n<div>* Consider dexamethasone suppression test for adrenal adenoma.<\/div>\n<div><span> 8. Practical Recommendations<\/span><\/div>\n<div>\u2013 Prefer spironolactone over other MRAs (affordable, widely available).<\/div>\n<div>\u2013 Use epithelial sodium channel blockers (such as amiloride or triamterene) only if mineralocorticoid receptor antagonists (MRAs) are not an option.<\/div>\n<div><span> 9. Global Adoption &amp; Cost-Effectiveness<\/span><\/div>\n<div>\u2013 Countries like Japan, China, and Australia already implement routine PA screening, showing long-term cost savings.<\/div>\n<div><span> 10. Expert Opinions<\/span><\/div>\n<div>\u2013 Dr. Cohen: New guidelines simplify screening, remove barriers, and improve diagnosis.<\/div>\n<div>\u2013 Dr. Auchus: Supports broader screening, especially in resistant hypertension, though notes age\/patient selection might refine strategy.<\/div>\n<div>\ud83d\udd17 Full article (Medscape):<\/div>\n<div><\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.medscape.com\/viewarticle\/1000085\">https:\/\/www.medscape.com\/viewarticle\/1000085<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>All individuals with hypertension should be screened for primary aldosteronism (PA) \ud83d\udd39 Key Summary: New Guidelines on Primary Aldosteronism (PA) Screening \u2013 July 2025 1. Universal PA Screening \u2013 All individuals with hypertension should be screened for primary aldosteronism (PA) using aldosterone and renin measurements. \u2013 The aldosterone-to-renin ratio (ARR) is the diagnostic cornerstone. 2. [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-7939","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7939","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7939"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7939\/revisions"}],"predecessor-version":[{"id":7940,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7939\/revisions\/7940"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7939"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7939"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7939"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}