Hypertension patients should be tested for primary aldosteronism

A simple blood test for the adrenal disease known as primary aldosteronism (PA) could save more than half a million Australians with hypertension (high blood pressure) from unnecessary illness, medication and expense.

That’s according to a new study led by the Hudson Institute of Medical Research, which found that of the one in three Australian adults with high blood pressure, at least 10% have PA; this equates to approximately 600,000 people in Australia. The research has been published in the Medical Journal of Australia.

In people with PA the adrenal glands produce too much aldosterone, a salt-retaining hormone. As well as high blood pressure, PA increases the risk of stroke, heart attack and kidney disease, but it is rarely diagnosed. Yet, if it is accurately diagnosed, PA can be cured or effectively treated using a simple medication.

Dr Jun Yang heads the Endocrine Hypertension Research Group at the Hudson Institute. Her team asked 70 general practitioners to test patients with high blood pressure for PA, and the results were surprising.

“Before the study these GPs reported less than one in every thousand of their patients having PA, but once they started testing for it the figure jumped to 14%,” Dr Yang said.

“People with high blood pressure are often prescribed a range of medications to manage it, but if PA is the cause, those medicines won’t help the condition and may even be harmful to their health. So it is vital that these patients are tested for PA.”

GP Dr Edward Tsui was part of the study, and surprised to see four out of the first 13 people he screened (and six out of 60 in all) being diagnosed with PA. He said, “Findings suggesting one in seven people with newly diagnosed hypertension could have PA would be a very significant reason for GPs to screen for the condition, and should prompt a review of the current guidelines for initial hypertension management.

“Knowing that early detection and treatment of PA can reduce the long-term risk of significant hypertensive complications has been extremely satisfying. The simplicity of a blood test, and the potential to effectively treat the condition with a single medication in most cases, has the potential to massively reduce the burden of disease on the patient and financial costs to the community.”

One person who benefited from the research was David Wyatt, who was first diagnosed with high blood pressure over 15 years ago and was told he would remain on medication for the rest of his life. It was only a couple of years ago, after developing arrhythmia and ending up in hospital, that he was referred to Dr Yang and swiftly diagnosed with PA. With the PA now treated, Wyatt’s blood pressure currently sits on the low end of normal.

Dr Yang concluded that greater knowledge of PA, and more testing when patients first show signs of high blood pressure, will improve many people’s health and quality of life. “It also makes sense financially, as effective treatment of PA will cut the costs of unnecessary medications, preventable heart disease and premature deaths,” she said.

Image credit: ©stock.adobe.com/au/DragonImages

Please follow us and share on Twitter and Facebook. You can also subscribe for FREE to our weekly newsletters and bimonthly magazine.