Primary aldosteronism: from case detection to histopathology with up to 6 years of follow‐up

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2017-04, Vol.19 (4), p.424-430
• Main Authors: Jonsdottir, Gudbjörg, Gudmundsson, Jon, Birgisson, Gudjon, Sigurjonsdottir, Helga Agusta
• Format: Article
• Language: English
• Subjects: Adrenal Gland Neoplasms - surgery; Adrenal Glands - blood supply; Adrenalectomy - methods; Adult; Aged; Female; Humans; Hyperaldosteronism - diagnosis; Hyperaldosteronism - surgery; Hyperplasia; Hypertension - drug therapy; Hypertension and Parkinson's Disease; Iceland - epidemiology; Male; Middle Aged; Original Paper; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/jch.12947

The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long‐term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007–2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling. Patients with unilateral disease were offered treatment with adrenalectomy. A total of 33 patients were diagnosed with PA during the study period: 17 patients with bilateral disease and 16 with unilateral disease. Results from salt loading test were positive in 90% of patients. In patients with adenoma, 36% were responsive on their positional test and computed tomography scan showed a nodule in 73%. All patients with unilateral disease had a lateralization index ≥3. After surgery, patients had lower systolic blood pressure (P