{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:35:39Z","timestamp":1788561339005,"version":"build-2803163510"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,8,22]],"date-time":"2021-08-22T00:00:00Z","timestamp":1629590400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary aldosteronism (PA) accounts for 3.2\u201312.7% of hypertension in primary care but is often diagnosed late, if at all. A delayed or missed diagnosis leads to poor blood pressure control and greater cardiovascular risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To analyse the impact of Victoria's first dedicated endocrine hypertension service (EHS) on the pattern of PA diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Socio\u2010demographic and clinical data from all patients who attended the EHS since July 2016 (<jats:italic>n<\/jats:italic> =\u2009267) was collected prospectively. Patients were divided into Year 1 (Y1), Year 2 (Y2) and Year 3 (Y3), based on their first visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of primary care referrals increased (20% in Y1, 47% in Y2, 52% in Y3) with more referrals being made for treatment\u2010naive hypertension (3% in Y1, 14% in Y2, 19% in Y3). Among PA patients, the median duration of hypertension prior to their first visit decreased (11\u2009years in Y1, 10\u2009years in Y2, 7\u2009years in Y3), and the prevalence of end\u2010organ damage decreased (44% in Y1, 42% in Y2, 33% in Y3). Targeted management of PA improved clinical and biochemical outcomes. The average blood pressure reduction following targeted management increased from 16\/12\u2009mmHg in Y1 to 23\/12\u2009mmHg in Y3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The EHS, with its strong component of general practitioner engagement, led to increased primary care referrals and PA detection earlier in the course of hypertension. Referred patients were on fewer antihypertensives and had less end\u2010organ damage which simplified the diagnostic process, allowing targeted treatment to be commenced earlier and patient outcomes optimised.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.14879","type":"journal-article","created":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T11:09:50Z","timestamp":1588504190000},"page":"1255-1261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of Victoria's first dedicated endocrine hypertension service on the pattern of primary aldosteronism diagnoses"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0749-247X","authenticated-orcid":false,"given":"Yin Yu","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Endocrinology Monash Health  Melbourne Victoria Australia"},{"name":"School of Clinical Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Libianto","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Melbourne Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmy","family":"Shen","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences Monash University  Melbourne Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morag J.","family":"Young","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Melbourne Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":false,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Melbourne Victoria Australia"},{"name":"School of Clinical Sciences Monash University  Melbourne Victoria Australia"},{"name":"Centre for Endocrinology and Metabolism Hudson Institute of Medical Research  Melbourne Victoria 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