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Progress in Primary Aldosteronism 2019: New Players on the Block?

原发性醛固酮增多症 2019 的进展: 街区的新玩家?

  • 影响因子:2.35
  • DOI:10.1055/a-1156-9926
  • 作者列表:"Reincke M","Beuschlein F","Williams TA
  • 发表时间:2020-06-01
Abstract

:Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated aldosterone to renin ratio. It is nowadays the universally accepted main cause of endocrine hypertension. According to the most recent epidemiological data, PA is present in 5.8% of unselected hypertensives in primary care, 6-12% of hypertensives treated in hypertension centers, and up to 30% in subjects with resistant hypertension 1. Despite this high prevalence, a recent survey demonstrated that screening for PA is not universally followed. Renin and aldosterone measurements, the basis for PA screening, are currently performed by only 7% of general practitioners in Italy and 8% in Germany 2. Accordingly, the prevalence of PA was low with 1% among hypertensives in Italy and 2% in Germany. In a retrospective cohort study of 4660 patients with resistant hypertension in California the screening rate for PA was 2.1% 3. Based on these data, it is clear that we still miss the majority of PA cases, despite advances in diagnosis and therapy.

摘要

: 原发性醛固酮增多症 (PA) 的特征是肾上腺醛固酮分泌不适当高,血浆肾素连续低,醛固酮与肾素比值升高引起的高血压。它是目前公认的内分泌高血压的主要病因。根据最新的流行病学数据,PA 存在于初级保健中 5.8% 的未经选择的高血压患者中,高血压中心治疗的高血压患者中 6-12%,在顽固性高血压患者中高达 30%。尽管患病率很高,但最近的一项调查表明,PA 筛查并不是普遍遵循的。肾素和醛固酮测量是 PA 筛查的基础,目前意大利只有 7% 的全科医生和德国的 8% 2。因此,PA 的患病率较低,意大利为 1%,德国为 2%。在一项对加州 4660 例顽固性高血压患者的回顾性队列研究中,PA 的筛查率为 2.1% 3。根据这些数据,很明显,尽管诊断和治疗取得了进展,但我们仍然错过了大多数 PA 病例。

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