{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:29:49Z","timestamp":1792772989588,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1194576"],"award-info":[{"award-number":["APP1194576"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the sustained impact of the Endocrine Hypertension Service on primary aldosteronism (PA) diagnosis and management over a subsequent 3\u2010year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PA is a prevalent yet underdiagnosed cause of secondary hypertension, associated with increased cardiovascular, renal and metabolic risk. Limited awareness, resources and expertise contribute to delays in diagnosis and treatment. A dedicated Endocrine Hypertension Service previously improved PA screening and increased primary care referrals in its first 3\u2009years (2016\u20132019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of consecutive new patients seen at a tertiary Endocrine Hypertension Service in Victoria, Australia, from 1 July 2019 to 30 June 2022, including significant COVID\u201019 disruptions. Clinical data were analysed by referral year (Y1: 2019\/2020, Y2: 2020\/2021, Y3: 2021\/2022) to assess changes over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 457 new patients were assessed, with referrals increasing over time (Y1: 115; Y2: 156; Y3: 186). Most referrals originated from primary care (50%), followed by cardiology (23%). At presentation, 20% of patients were treatment\u2010na\u00efve, median hypertension duration was 4\u2009years, and 22% had end\u2010organ damage. Of the cohort, 213 had PA, 171 did not, and 73 were 'undetermined' due to incomplete work\u2010up. Among 171 patients with PA treated medically, 78% achieved complete biochemical response and 46% complete clinical response on MRA monotherapy, as defined by the Primary Aldosteronism Medical Outcome (PAMO) criteria. Among 34 patients who underwent unilateral adrenalectomy, 86% achieved complete biochemical response and 39% complete clinical response, according to the Primary Aldosteronism Surgical Outcome (PASO) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Growth in referrals, earlier detection and high treatment response rates highlight the sustained effectiveness of a structured pathway for timely PA diagnosis and management, despite COVID\u201019 disruptions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70526","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:25:41Z","timestamp":1784294741000},"page":"1735-1747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving primary aldosteronism diagnosis and treatment: outcomes from an endocrine hypertension service"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6947-2935","authenticated-orcid":false,"given":"Minn W.","family":"Chow","sequence":"first","affiliation":[{"name":"Department of Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrislyn","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-4289","authenticated-orcid":false,"given":"Jimmy","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Reproductive Health Hudson Institute of Medical Research  Clayton Victoria Australia"},{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0948-2072","authenticated-orcid":false,"given":"Peter J.","family":"Fuller","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Reproductive Health Hudson Institute of Medical Research  Clayton Victoria Australia"},{"name":"Department of Endocrinology Monash Health  Clayton 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 Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Reproductive Health Hudson Institute of Medical Research  Clayton Victoria Australia"},{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Libianto","sequence":"additional","affiliation":[{"name":"Department of Medicine Monash University  Clayton Victoria Australia"},{"name":"Centre for Endocrinology and Reproductive Health Hudson Institute of Medical Research  Clayton Victoria Australia"},{"name":"Department of Endocrinology Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061"},{"key":"e_1_2_9_3_1","first-page":"2339","article-title":"Management of primary aldosteronism: the 2023 Endocrine Society Clinical Practice Guideline","volume":"108","author":"Reincke M","year":"2023","journal-title":"J Clin Endocrinol 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Available from URL:https:\/\/www.primaryaldosteronism.org\/medical_center\/monash-health-and-hudson-institute-of-medical-research\/"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-05-18-4587"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14879"},{"key":"e_1_2_9_23_1","first-page":"127","article-title":"Monash partners protocol for the diagnosis and management of primary aldosteronism","volume":"49","author":"Yang J","year":"2024","journal-title":"Monash Health"},{"key":"e_1_2_9_24_1","unstructured":"Endocrine Society of Australia.Medication switching to test for primary aldosteronism (Internet). Australia: Endocrine Society of Australia; (cited 2025 Mar 30). 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