{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:34:45Z","timestamp":1790832885109,"version":"4.1.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T00:00:00Z","timestamp":1659657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Primary aldosteronism (PA) is the most common cause of secondary hypertension. The diagnosis of PA currently requires multiple complicated measures. The aims of this study were to identify easy-to-obtain clinical and biochemical predictors, and to create predictive model to facilitate the identification of a patient at high risk of having PA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>This 2-year retrospective cohort study was conducted at a tertiary care medical center. A total of 305 patients who had been tested for plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were identified. Patients with incomplete results of PAC and PRA and those who had an established diagnosis of Cushing\u2019s syndrome or pheochromocytoma were excluded. Logistic regression analysis was used to identify significant predictors and to create predictive model of PA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>PA was diagnosed in 128 of the patients (41.96%). Significant predictive factors for PA were age &gt;60 years (OR 2.12, p = 0.045), female (OR 1.65, p&lt;0.001), smoking (OR 2.79, p&lt;0.001), coronary artery disease (OR 2.29, p&lt;0.001), obstructive sleep apnea (OR 1.50, p = 0.017), systolic blood pressure &gt;160 mmHg (OR 1.15, P&lt;0.001), serum potassium &lt;3 mEq\/L (OR 3.72, p = 0.030), fasting blood glucose &gt;126 mg\/dL (OR 0.48, p = 0.001) and estimated glomerular filtration rate (eGFR) &lt;60 mL\/min\/1.73m<jats:sup>2<\/jats:sup> (OR 1.79, p = 0.001). Predictive model was created with a total score ranged from 0 to 42. A score above 7.5 indicated a higher probability of having PA with a sensitivity of 72% and a specificity of 70%. The diagnostic performance of the predictive model based on area under the curve was 71%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The clinical and biochemical predictive factors including predictive model identified in this study can be employed as an additional tool to help identify patients at risk of having PA and could help reduce the number of screening and confirmation tests required for PA.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0272049","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T17:35:26Z","timestamp":1659720926000},"page":"e0272049","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Clinical and biochemical predictors and predictive model of primary aldosteronism"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-3951","authenticated-orcid":true,"given":"Worapaka","family":"Manosroi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natthanan","family":"Tacharearnmuang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9737-4110","authenticated-orcid":true,"given":"Pichitchai","family":"Atthakomol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,5]]},"reference":[{"issue":"6","key":"pone.0272049.ref001","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1161\/01.HYP.0000040261.30455.B6","article-title":"Hyperaldosteronism among black and white subjects with resistant hypertension","volume":"40","author":"DA 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primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis","volume":"6","author":"S Monticone","year":"2018","journal-title":"The lancet Diabetes & endocrinology"},{"issue":"9","key":"pone.0272049.ref005","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: an endocrine society clinical practice guideline","volume":"93","author":"JW Funder","year":"2008","journal-title":"The Journal of clinical endocrinology and metabolism"},{"key":"pone.0272049.ref006","doi-asserted-by":"crossref","first-page":"100029","DOI":"10.1016\/j.ijchy.2020.100029","article-title":"The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism","volume":"5","author":"GP Rossi","year":"2020","journal-title":"International Journal of Cardiology 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Ratio for Primary Aldosteronism (AQUARR) Study","volume":"6","author":"G Maiolino","year":"2017","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"pone.0272049.ref010","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7326\/M20-0065","article-title":"The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study","volume":"173","author":"JM Brown","year":"2020","journal-title":"Ann Intern Med"},{"key":"pone.0272049.ref011","doi-asserted-by":"crossref","first-page":"162804","DOI":"10.4061\/2011\/162804","article-title":"Changes in the perceived epidemiology of primary hyperaldosteronism","volume":"2011","author":"RM Fagugli","year":"2011","journal-title":"Int J Hypertens"},{"issue":"14","key":"pone.0272049.ref012","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 Primary Care Practice","volume":"69","author":"S 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Results of the German Conn\u2019s Registry","volume":"42","author":"M Reincke","year":"2010","journal-title":"Horm Metab Res"},{"issue":"2","key":"pone.0272049.ref031","doi-asserted-by":"crossref","first-page":"e0170250","DOI":"10.1371\/journal.pone.0170250","article-title":"Prevalence of diabetes and unrecognized diabetes in hypertensive patients aged 40 to 79 years in southwest China","volume":"12","author":"XB Huang","year":"2017","journal-title":"PLoS One"},{"issue":"6","key":"pone.0272049.ref032","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1007\/s11906-008-0092-0","article-title":"Resistant hypertension and hyperaldosteronism","volume":"10","author":"CC Gonzaga","year":"2008","journal-title":"Current Hypertension Reports"},{"issue":"6","key":"pone.0272049.ref033","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1111\/cen.14409","article-title":"High prevalence and a long delay in the diagnosis of primary aldosteronism among patients with young-onset hypertension","volume":"94","author":"S Alam","year":"2021","journal-title":"Clin Endocrinol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T17:36:02Z","timestamp":1659720962000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0272049"}},"subtitle":[],"editor":[{"given":"Stephen L.","family":"Atkin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,5]]},"references-count":33,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0272049","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,5]]}}}