Increasing incidence of primary aldosteronism – yet an underdiagnosed disorder

Eleftheria Gkaniatsa; Eva Ekerstad; Emanuela Gavric; Penelope Trimpou; Daniel S. Olsson; Gudmundur Johannsson; Oskar Ragnarsson

doi:10.1530/endoabs.73.AEP39

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Endocrine Abstracts (2021) 73 AEP39 | DOI: 10.1530/endoabs.73.AEP39

ECE2021 Audio Eposter Presentations Adrenal and Cardiovascular Endocrinology (80 abstracts)

Increasing incidence of primary aldosteronism – yet an underdiagnosed disorder

Eleftheria Gkaniatsa ¹ , Eva Ekerstad ² , Emanuela Gavric ³ , Penelope Trimpou ¹ , Daniel S. Olsson ¹ , Gudmundur Johannsson ¹ & Oskar Ragnarsson ¹

Err

Author affiliations

¹Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and The Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden, Gothenurg, Sweden; ²Department of Internal Medicine, Norra Älvsborgs Länssjukhus, Trollhättan, Sweden; ³Department of Endocrinology and Diabetes, Kungälvs Sjukhus, Kungälv, Sweden

Context

Primary aldosteronism (PA) is the most common cause of secondary hypertension. Yet, the incidence of PA in the population has not been studied.

Objective

To estimate the incidence of PA in western Sweden.

Design and methods

Patients who had received a diagnostic code for PA between 1987 and 2016 were identified in the Swedish National Patient Registry. Assessment of clinical and biochemical data retrieved from patient records was used to validate the diagnosis. The annual incidence of PA was calculated by using the number of inhabitants in the Västra Götaland County as reference.

Results

Of 570 identified patients, 473 (83 %) had confirmed PA. Eligible for the incidence analysis were 416 patients, 248 (60%) men and 168 (40%) women, diagnosed with PA between 1987–2016. The median (mean) age at diagnoses was 56 ± 12 years. The median (interquartile range) annual incidence was 2 (1–2) cases per million between 1987 and 1996, 6 (4–9) cases per million between 1997 and 2006 and 17 (12–24) cases per million between 2007 and 2016. At the end of the study (December 31^st 2016), 386 patients with confirmed PA were alive and living in the Västra Götaland County, giving a prevalence of 231 cases per million (0.022%).

Conclusions

Despite increasing detection rate, PA is still underdiagnosed. Given the serious consequences of untreated PA, the noticeable low prevalence at the end of the study illustrates a need for measures aiming at increasing the awareness of PA among health care providers.