Are We Only Detecting the Tip of the Iceberg? A Nationwide Study on Primary Aldosteronism with up to 8-Year Follow-up

ABSTRACT

Background

Long-term follow-up studies on primary aldosteronism (PA) are lacking.

Objective

We aim to review results of diagnostic procedures and histopathology for patients diagnosed during 2012–2016 in Iceland, compare unilateral (UD) and bilateral disease (BD) and assess treatment response.

Methods

Thirty-two patients aged 28–88 were diagnosed and treated according to guidelines.

Results

The majority had BD. Everyone needed potassium supplementation at case detection. We saw a reduction in systolic blood pressure (p < .001, both groups), antihypertensive agents (p = .002 UD and p = .04 BD) and potassium supplementation (p < .001, both groups).

Conclusion

Similar treatment response was seen in both subgroups. Ratio of hypokalemia and number of cases indicates severe PA underdiagnosis in Iceland.

KEYWORDS:

• Primary aldosteronism
• saline infusion test
• adrenal venous sampling
• potassium supplementation
• adrenalectomy

Acknowledgments

The authors want to thank Ubaldo Benitez Hernandez, statistician and natural scientist at LUH, for his help with statistical analysis regarding follow-up, and Gudmundur Sigthorsson, MD, PhD, at LUH for assessing laboratory values.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Data Availability Statement

Restrictions apply to the data supporting these findings because they were used under license. The corresponding author will on request detail the restrictions and any conditions under which access to some data may be provided.

Supplementary Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the Landspitali University Hospital Research Fund under Grant number [B-2020-008].