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China nationwide screening and registry of primary aldosteronism in hypertensive patients

Abstract

In the framework of the China Hypertension Control Initiatives, the China Primary Aldosteronism Prospective Study was designed as a nationwide multicenter programme for the screening and registry of primary aldosteronism in hypertensive patients. The primary objective was to establish technological platforms, team and expertise for the screening, diagnosis and treatment of primary aldosteronism in cardiology outpatient clinics. From 18 July 2018 to 31 May 2020, 1329 patients from 14 cities had been screened. 348 (26.2%) patients had a plasma aldosterone-to-renin ratio of ≥40 (pg/ml)/(pg/ml) and enroled in the registry. 175 (50.3%) patients had confirmatory testing, of whom 163 (93.1%) had a confirmed diagnosis of primary aldosteronism.

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Fig. 1: Participation of the China nationwide screening and registry of primary aldosteronism.

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References

  1. Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35:1245–54.

    Article  Google Scholar 

  2. Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC, et al. Study heterogeneity and estimation of prevalence of primary aldosteronism: a systematic review and meta-regression analysis. J Clin Endocrinol Metab. 2016;101:2826–35.

    Article  Google Scholar 

  3. Monticone S, Burrello J, Tizzani D, Bertello C, Viola A, Buffolo F, et al. Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. J Am Coll Cardiol. 2017;69:1811–20.

    Article  Google Scholar 

  4. Prejbisz A, Florczak E, Klisiewicz A, Dobrowolski P, Janaszek-Sitkowska H, Bieleń P, et al. Relationship between primary aldosteronism and obstructive sleep apnoea, metabolic abnormalities and cardiac structure in patients with resistant hypertension. Endokrynol Pol. 2013;64:363–7.

    Article  CAS  Google Scholar 

  5. Umpierrez GE, Cantey P, Smiley D, Palacio A, Temponi D, Luster K, et al. Primary aldosteronism in diabetic subjects with resistant hypertension. Diabetes Care. 2007;30:1699–703.

    Article  CAS  Google Scholar 

  6. Monticone S, D’Ascenzo F, Moretti C, Williams TA, Veglio F, Gaita F, et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018;6:41–50.

    Article  CAS  Google Scholar 

  7. Rossi GP, Maiolino G, Flego A, Belfiore A, Bernini G, Fabris B, et al. Adrenalectomy lowers incident atrial fibrillation in primary aldosteronism patients at long term. Hypertension. 2018;71:585–91.

    Article  CAS  Google Scholar 

  8. Rossi GP, Cesari M, Cuspidi C, Maiolino G, Cicala MV, Bisogni V, et al. Long-term control of arterial hypertension and regression of left ventricular hypertrophy with treatment of primary aldosteronism. Hypertension. 2013;62:62–69.

    Article  CAS  Google Scholar 

  9. Zhu L, Zhang Y, Zhang H, Zhou W, Shen Z, Zheng F, et al. Comparison between adrenal venous sampling and computed tomography in the diagnosis of primary aldosteronism and in the guidance of adrenalectomy. Medicine. 2016;95:e4986.

    Article  Google Scholar 

  10. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016;175:G1–G34.

    Article  CAS  Google Scholar 

  11. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2016;101:1889–916.

    Article  CAS  Google Scholar 

  12. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138:e426–e483.

    PubMed  Google Scholar 

  13. Rossi GP, Ceolotto G, Rossitto G, Seccia TM, Maiolino G, Berton C, et al. Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension. Clin Chem Lab Med. 2016;54:1441–50.

    Article  CAS  Google Scholar 

  14. Glinicki P, Jeske W, Bednarek-Papierska L, Kruszyńska A, Gietka-Czernel M, Rosłonowska E, et al. The ratios of aldosterone / plasma renin activity (ARR) versus aldosterone / direct renin concentration (ADRR). J Renin Angiotensin Aldosterone Syst. 2015;16:1298–305.

    Article  CAS  Google Scholar 

  15. Chen X, Xu SK, Guo QH, Hu Z, Wang HY, Yu J, et al. Barriers to blood pressure control in China in a large opportunistic screening. J Clin Hypertens. 2020;22:835–41.

    Article  CAS  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge the active participation of the investigators and patients of the ChinaPAPS project.

Funding

J-GW was financially supported by grants from the National Natural Science Foundation of China (grants 82070435 and 91639203), Beijing, China and the Shanghai Commissions of Science and Technology (grant 19DZ2340200) and Health (a special grant for “Leading Academics”), Shanghai, China.

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Correspondence to Ji-Guang Wang.

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Chen, X., Cheng, YB. & Wang, JG. China nationwide screening and registry of primary aldosteronism in hypertensive patients. J Hum Hypertens 35, 157–161 (2021). https://doi.org/10.1038/s41371-020-00458-4

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