{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:35:38Z","timestamp":1788561338999,"version":"build-2803163510"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"07\/08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Primary aldosteronism (PA), once considered a rare disease, is being increasingly\n                    recognized as an important cause of hypertension. It is associated with higher\n                    rates of cardiovascular complications compared to blood pressure-matched\n                    essential hypertension. Targeted treatments are available which can mitigate the\n                    excess cardiovascular risks and, in some cases, cure hypertension. Making a\n                    timely diagnosis of PA is, therefore, highly beneficial for patients.\n                    Furthermore, numerous studies from different parts of the world have found PA to\n                    be a relatively common disease that can affect patients in any stage of\n                    hypertension, regardless of their age or potassium levels. Despite this\n                    well-established data, the current rate of PA detection is appallingly low, much\n                    below its actual prevalence. This review explores the challenges that clinicians\n                    often face in diagnosing PA and offers strategies that may improve the detection\n                    of this potentially curable form of hypertension.<\/jats:p>","DOI":"10.1055\/a-2048-6213","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:57:20Z","timestamp":1683766640000},"page":"402-408","source":"Crossref","is-referenced-by-count":3,"title":["Improving Detection Rates for Primary Aldosteronism"],"prefix":"10.1055","volume":"131","author":[{"given":"Renata","family":"Libianto","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research, Clayton, Victoria,\n                    Australia"},{"name":"Monash Health, Clayton, Victoria"},{"name":"Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stowasser","sequence":"additional","affiliation":[{"name":"University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Russell","sequence":"additional","affiliation":[{"name":"Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Fuller","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research, Clayton, Victoria,\n                    Australia"},{"name":"Monash Health, Clayton, Victoria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research, Clayton, Victoria,\n                    Australia"},{"name":"Monash Health, Clayton, Victoria"},{"name":"Monash University, Clayton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: Case detection, diagnosis, and\n                    treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"J W Funder","year":"2016","journal-title":"J Clin Endocrinol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.jacc.2005.01.015","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary\n                    aldosteronism","volume":"45","author":"P Milliez","year":"2005","journal-title":"JACC"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"4826","DOI":"10.1210\/jc.2013-2805","article-title":"Long-term cardio- and cerebrovascular events in patients with primary\n                    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mineralocorticoid receptor antagonist use\n                    among U.S. veterans: A retrospective cohort study","volume":"174","author":"J B Cohen","year":"2020","journal-title":"Ann Intern Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1038\/s41371-020-0336-2","article-title":"Primary aldosteronism is a public health issue: challenges and\n                    opportunities","volume":"34","author":"R Libianto","year":"2020","journal-title":"J Hum Hypertens"},{"key":"ref11","first-page":"3","article-title":"Primary aldosteronism, a new clinical syndrome","volume":"45","author":"JW. Conn","year":"1955","journal-title":"J Lab Clin Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1016\/j.jacc.2017.01.052","article-title":"Prevalence and clinical manifestations of primary aldosteronism encountered in\n                    primary care practice","volume":"69","author":"S Monticone","year":"2017","journal-title":"JACC"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1016\/j.jacc.2020.02.052","article-title":"Primary aldosteronism in patients in China with recently detected\n                    hypertension","volume":"75","author":"Z Xu","year":"2020","journal-title":"JACC"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"408","DOI":"10.5694\/mja2.51438","article-title":"Detecting primary aldosteronism in Australian primary care: A prospective\n                    study","volume":"216","author":"R Libianto","year":"2022","journal-title":"Med J Aust"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1291\/hypres.30.111","article-title":"Prevalence of primary aldosteronism among unselected hypertensive patients: A\n                    prospective study based on the use of an aldosterone\/renin ratio above\n                    25 as a screening test","volume":"30","author":"R Fogari","year":"2007","journal-title":"Hypertens Res"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e114","DOI":"10.3399\/bjgp18X694589","article-title":"Prevalence of primary aldosteronism in primary care: A cross-sectional\n                    study","volume":"68","author":"S C Kayser","year":"2018","journal-title":"Br J Gen Pract"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.4158\/E161332.OR","article-title":"Prevalence of primary aldosteronism in an urban hypertensive population","volume":"22","author":"S J Galati","year":"2016","journal-title":"Endocr Pract"},{"key":"ref18","first-page":"212","article-title":"Screening for primary aldosteronism in a primary care unit","volume":"14","author":"C Volpe","year":"2013","journal-title":"JRAAS"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/hr.2010.166","article-title":"Prevalence of primary aldosteronism among prehypertensive and stage 1\n                    hypertensive subjects","volume":"34","author":"Y Ito","year":"2011","journal-title":"Hypertens Res"},{"key":"ref20","first-page":"57","article-title":"Primary aldosteronism among newly diagnosed and untreated hypertensive patients\n                    in a Swedish primary care area","volume":"29","author":"C Westerdahl","year":"2011","journal-title":"Scan J Prim Health Care"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1038\/sj.jhh.1001948","article-title":"Prevalence of primary hyperaldosteronism in mild to moderate hypertension\n                    without hypokalaemia","volume":"20","author":"J S Williams","year":"2006","journal-title":"J Hum Hypertens"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1080\/02813430600830931","article-title":"High frequency of primary hyperaldosteronism among hypertensive patients from a\n                    primary care area in Sweden","volume":"24","author":"C Westerdahl","year":"2006","journal-title":"Scan J Prim Health Care"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1373\/clinchem.2004.041780","article-title":"Screening for primary aldosteronism in essential hypertension: diagnostic\n                    accuracy of the ratio of plasma aldosterone concentration to plasma renin\n                    activity","volume":"51","author":"G L Schwartz","year":"2005","journal-title":"Clin Chem"},{"key":"ref24","first-page":"2854","article-title":"Prevalence of primary aldosteronism among Asian hypertensive patients in\n                    Singapore","volume":"85","author":"K C Loh","year":"2000","journal-title":"J Clin Endocrinol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1161\/01.HYP.0000079505.25750.11","article-title":"Primary aldosteronism and hypertensive disease","volume":"42","author":"L Mosso","year":"2003","journal-title":"Hypertension"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1440-1681.1993.tb01687.x","article-title":"Evidence that primary aldosteronism may not be uncommon: 12% incidence\n                    among antihypertensive drug trial volunteers","volume":"20","author":"R D Gordon","year":"1993","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"ref27","first-page":"8647026","article-title":"Age-related cutoffs of plasma aldosterone\/renin concentration for\n                    primary aldosteronism screening","volume":"2018","author":"L Ma","year":"2018","journal-title":"Int J Endocrinol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1210\/er.2018-00139","article-title":"The expanding spectrum of primary aldosteronism: Implications for diagnosis,\n                    pathogenesis, and treatment","volume":"39","author":"A Vaidya","year":"2018","journal-title":"Endocr Rev"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1055\/a-1120-8623","article-title":"Funder JW. Primary aldosteronism: Where are we now? Where to from here?","volume":"52","year":"2020","journal-title":"Horm Metab Res"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"2826","DOI":"10.1210\/jc.2016-1472","article-title":"Study heterogeneity and estimation of prevalence of primary aldosteronism: A\n                    systematic review and meta-regression Analysis","volume":"101","author":"S C Kayser","year":"2016","journal-title":"J Clin Endocrinol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1097\/HJH.0000000000002441","article-title":"Prevalence of primary aldosteronism and association with cardiovascular\n                    complications in patients with resistant and refractory hypertension","volume":"38","author":"M Parasiliti-Caprino","year":"2020","journal-title":"J Hypertens"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/S0140-6736(15)00257-3","article-title":"Spironolactone versus placebo, bisoprolol, and doxazosin to determine the\n                    optimal treatment for drug-resistant hypertension (PATHWAY-2): A randomised,\n                    double-blind, crossover trial","volume":"386","author":"B Williams","year":"2015","journal-title":"Lancet"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S2213-8587(18)30071-8","article-title":"Endocrine and haemodynamic changes in resistant hypertension, and blood pressure\n                    responses to spironolactone or amiloride: The PATHWAY-2 mechanisms\n                    substudies","volume":"6","author":"B Williams","year":"2018","journal-title":"Lancet Diab Endocrinol"},{"key":"ref35","first-page":"105","article-title":"Determining the prevalence of primary aldosteronism in patients with new-onset\n                    type 2 diabetes and hypertension","author":"Y Hu","year":"2020","journal-title":"J Clin Endocrinol"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/HJH.0000000000002250","article-title":"Atrial fibrillation as presenting sign of primary aldosteronism: Results of the\n                    Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive\n                    (PAPPHY) Study","volume":"38","author":"T M Seccia","year":"2020","journal-title":"J Hypertens"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1097\/HJH.0000000000001088","article-title":"Guidelines for primary aldosteronism: Uptake by primary care physicians in\n                    Europe","volume":"34","author":"P Mulatero","year":"2016","journal-title":"J Hypertens"},{"key":"ref38","first-page":"1691","article-title":"Diagnostic rate of primary aldosteronism in Emilia-Romagna, Northern Italy,\n                    during 16 years (2000-2015)","author":"E Rossi","journal-title":"J Hypertens 2017; 35"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5694\/mja17.00783","article-title":"Is it time to screen all patients with hypertension for primary\n                    aldosteronism?","volume":"209","author":"J Yang","year":"2018","journal-title":"Med J Aust"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"712","DOI":"10.31128\/AJGP-05-18-4587","article-title":"Current pattern of primary aldosteronism diagnosis: Delayed and complicated","volume":"47","author":"Y Y Lim","year":"2018","journal-title":"Aust J Gen Pract"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1161\/HYPERTENSIONAHA.119.14359","article-title":"Screening rates for primary aldosteronism in resistant hypertension: A cohort\n                    study","volume":"75","author":"G 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Med"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1097\/HJH.0000000000002046","article-title":"Assessing the quality of guidelines for primary aldosteronism: Which guidelines\n                    are worth applying in diverse settings?","volume":"37","author":"J Wu","year":"2019","journal-title":"J Hypertens"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"3266","DOI":"10.1210\/jc.2008-0104","article-title":"Case detection, diagnosis, and treatment of patients with primary aldosteronism:\n                    An endocrine society clinical practice guideline","volume":"93","author":"J W Funder","year":"2008","journal-title":"J Clin Endocrinol"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017\n                    ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA\n                    guideline for the prevention, detection, evaluation, and management of high\n                    blood pressure in adults: A report of the American College of\n                    Cardiology\/American Heart Association task force on clinical practice\n                    guidelines","volume":"71","author":"P K Whelton","year":"2018","journal-title":"JACC"},{"key":"ref54","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1097\/HJH.0000000000001940","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension: The\n                    Task Force for the management of arterial hypertension of the European Society\n                    of Cardiology and the European Society of Hypertension: The Task Force for the\n                    management of arterial hypertension of the European Society of Cardiology and\n                    the European Society of Hypertension","volume":"36","author":"B Williams","year":"2018","journal-title":"J Hypertens"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1111\/cen.14478","article-title":"Cost-effectiveness analysis of screening for primary aldosteronism in China","volume":"95","author":"N Li","year":"2021","journal-title":"Clin Endocrinol"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1111\/imj.14879","article-title":"Impact of Victoria's first dedicated endocrine hypertension service on\n                    the pattern of primary aldosteronism diagnoses","volume":"51","author":"Y Y Lim","year":"2021","journal-title":"Int Med J"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1161\/HYPERTENSIONAHA.121.18761","article-title":"Primary aldosteronism: Where are we now? Where to from here?","volume":"79","author":"J W Funder","year":"2022","journal-title":"Hypertension"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1161\/HYPERTENSIONAHA.120.15026","article-title":"2020 International Society of Hypertension Global Hypertension Practice\n                    Guidelines","volume":"75","author":"T Unger","year":"2020","journal-title":"Hypertension"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"e065250","DOI":"10.1136\/bmj-2021-065250","article-title":"Primary aldosteronism","volume":"377","author":"K W Choy","year":"2022","journal-title":"Br Med J"},{"key":"ref60","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/S0140-6736(17)32152-9","article-title":"Global, regional, and national age-sex specific mortality for 264 causes of\n                    death, 1980-2016: A systematic analysis for the Global Burden of Disease Study\n                    2016","volume":"390","author":"GBD 2016 Causes of Death\n                        Collaborators","year":"2017","journal-title":"Lancet"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1016\/S0140-6736(12)61766-8","article-title":"A comparative risk assessment of burden of disease and injury attributable to 67\n                    risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic\n                    analysis for the Global Burden of Disease Study 2010","volume":"380","author":"S S Lim","year":"2012","journal-title":"Lancet"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2048-6213.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T23:48:41Z","timestamp":1691797721000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2048-6213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,9]]},"references-count":57,"journal-issue":{"issue":"07\/08","published-online":{"date-parts":[[2023,8,11]]},"published-print":{"date-parts":[[2023,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2048-6213","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"value":"0947-7349","type":"print"},{"value":"1439-3646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,9]]}}}