Objective: To identify primary aldosteronism (PA) in newly diagnosed, treatment-naïve, hypertensive patients in primary care.
Design: Prospective study conducted in 2017-2020.
Setting: General Practitioners (GPs) from multiple practices across Melbourne (Victoria) were invited to screen their patients for PA at the time of the diagnosis of hypertension. Screening for PA was performed by measuring the aldosterone-to-renin ratio (ARR). Those with ARR ≥70 pmol/mU underwent the saline suppression test in a specialist referral centre to confirm the diagnosis of PA.
Participants: 247 primary care adults with blood pressure >140/90 mmHg on two or more occasions and not taking antihypertensive medications.
Main outcome measures: The diagnostic rate of PA, calculated as the percentage of patients with confirmed PA divided by the number of hypertensive patients screened for PA.
Results: Among the 247 participants, 62 (25%) had a positive screening test result and 35 (14% of all the participants; 95% confidence interval 10% to 19%) were confirmed to have PA. None of the patient characteristics (age, sex, blood pressure or serum potassium) distinguished the PA from the non-PA group.
Conclusion: PA was diagnosed in 14% of patients with newly diagnosed hypertension in primary care and GPs have an important role in actively screening for this specifically treatable cause of hypertension.