Indications for primary aldosteronism screening in people with hypertension and hyperparathyroidism: a multi-centre cohort study.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-07-03 DOI:10.1007/s12020-025-04323-7

A Jones, J Tan, T Dao, J Tan, P Wong, S Sztal-Mazer, F Milat, J Yang, C Gilfillan

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引用次数: 0

Abstract

Purpose: Parathyroid hormone (PTH) excess is associated with hypertension while elevated PTH has been observed in primary aldosteronism (PA). This study aimed to determine the proportion of patients with hyperparathyroidism who met Endocrine Society criteria for PA screening, and to assess current screening practices.

Methods: Multi-centre retrospective cohort study including patients attending outpatient endocrine clinics at three tertiary health services in Victoria, Australia between 2015-2019. Patients were included if they had an elevated PTH level and excluded if they had a secondary cause of hyperparathyroidism or a prior diagnosis of PA. Demographic, clinical and biochemical data were extracted from electronic medical records.

Results: Of 275 patients with hyperparathyroidism, hypertension was present in 51.6%; including 62.4% of patients with hypercalcaemia and 35.5% of those with normocalcaemia. Overall,15.6% (43/275) had a guideline indication for PA screening, including 21.8% (36/165) of those with hypercalcaemia and 6.4% (7/110) of those with normocalcaemia. Of those with hypertension, 30% (43/142) had a guideline indication for PA screening. The most common indication for screening was hypertension and hypokalaemia (16/43). Despite this, only 9.3% (4/43) were screened, with one confirmed PA diagnosis.

Conclusion: Hypertension is common in patients with hyperparathyroidism. A third of patients with hyperparathyroidism and hypertension had a guideline indication for PA screening, however screening remains substantially under-utilised. A prospective study is needed to evaluate the prevalence and impact of PA in patients with hyperparathyroidism.

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高血压和甲状旁腺功能亢进患者原发性醛固酮增多症筛查的适应症：一项多中心队列研究。

目的：甲状旁腺激素（PTH）过量与高血压有关，而PTH升高已在原发性醛固酮增多症（PA）中观察到。本研究旨在确定符合内分泌学会PA筛查标准的甲状旁腺功能亢进患者的比例，并评估目前的筛查做法。方法：多中心回顾性队列研究，包括2015-2019年在澳大利亚维多利亚州三家三级卫生服务机构内分泌门诊就诊的患者。如果患者的甲状旁腺激素水平升高，排除如果他们有甲状旁腺功能亢进的继发原因或先前诊断的PA。从电子病历中提取人口统计、临床和生化数据。结果：275例甲状旁腺功能亢进患者中，高血压占51.6%；包括62.4%的高钙血症患者和35.5%的正常钙血症患者。总体而言，15.6%（43/275）的患者有PA筛查的指南指征，包括21.8%（36/165）的高钙血症患者和6.4%（7/110）的正常钙血症患者。在高血压患者中，30%（43/142）有PA筛查的指导性指征。筛查的最常见适应症是高血压和低钾血症（16/43）。尽管如此，只有9.3%（4/43）进行了筛查，其中1例确诊为PA。结论：甲状旁腺功能亢进患者常见高血压。三分之一的甲状旁腺功能亢进和高血压患者有PA筛查的指导性指征，但筛查仍未得到充分利用。需要一项前瞻性研究来评估PA在甲状旁腺功能亢进患者中的患病率和影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.