{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:18:29Z","timestamp":1791494309684,"version":"4.3.4"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Uncontrolled hypertension is prevalent in sub\u2010Saharan Africa and a major contributor to premature morbidity. The reasons may not be identical to those reported in studies of Black patients in Western countries. Recent African immigration to western Canada permits the study of hypertension mechanisms in African Black patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Retrospective study of 15\u2009years' experience (2010\u20132025) with hypertensive first\u2010generation African immigrants to a resistant hypertension clinic in Alberta, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      With uniform screening for primary aldosteronism (PA), PA was found in 93% of all African patients (n=114) versus 46.8% in non\u2010African referred patients (n=792;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.0001). The majority had resistant hypertension, and hypokalemia was seen in two\u2010thirds; 87% had aldosterone levels &gt;277 pmol\/L, so diagnosis was not due solely to low renin. Only 17% had adrenal abnormalities on imaging. In those with adrenal vein sampling, there were no cases where unilateral adrenal disease was seen both before and after cosyntropin without adrenal nodules; contralateral suppression was present in just 14%. Cortisol cosecretion was present in many of those with visible adrenal nodules and in the few with adrenalectomy, none achieved both a complete clinical and biochemical response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among first\u2010generation African immigrants with hypertension, 93% fit a clear diagnosis of PA, a prevalence figure far in excess of any other population ever reported. Most of the PA phenotype was bilateral aldosterone excess; surgical cases and complete responders to adrenalectomy were rare. This, the largest detailed study of PA in African patients with hypertension, if confirmed, has important implications for hypertension assessment and treatment for African Black patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048888","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T10:52:06Z","timestamp":1784285526000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Bilateral Adrenal Primary Aldosteronism Is Uniformly Present in Hypertensive Afro\u2010Caribbean First\u2010Generation Immigrants to Western Canada"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-8497","authenticated-orcid":false,"given":"Alexander A.","family":"Leung","sequence":"first","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]},{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Wright","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-8894","authenticated-orcid":false,"given":"C. Benny","family":"So","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2753-4988","authenticated-orcid":false,"given":"Janice L.","family":"Pasieka","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0765-8185","authenticated-orcid":false,"given":"Stefan","family":"Przybojewski","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cori E.","family":"Caughlin","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Harvey","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3517-0910","authenticated-orcid":false,"given":"Caitlin","family":"Yeo","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin D.","family":"Hyrcza","sequence":"additional","affiliation":[{"name":"Alberta Precision Laboratories, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8129-9360","authenticated-orcid":false,"given":"Gregory A.","family":"Kline","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary","place":["Calgary, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31679-8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01330-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.7022"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-022-01826-x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.170308"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2022.12.024"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/hypertensionaha.121.17570"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.16879"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMms2029562"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmms2004740"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.abm7530"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.003823"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101197"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2402267121"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.24683"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijintrel.2020.10.001"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41576-020-00306-8"},{"key":"e_1_3_2_19_2","volume-title":"African Newcomers Now One of the Largest Immigrant Groups Moving to Alberta","author":"McGarvey D","year":"2022","unstructured":"McGarvey D. 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