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TUESDAY, December 29, 2020 (HealthDay News) – Patients with apparently treatment-resistant hypertension are rarely tested for primary aldosteronism, according to a study published online Dec. 29 in the Annals of Internal Medicine.
Jordana B. Cohen, MD, of the University of Pennsylvania in Philadelphia, and colleagues examined the test rate for primary aldosteronism and evidence-based hypertension management for treatment-resistant hypertension in a retrospective cohort study. Data was included for 269,010 US Veterans Health Administration veterans with apparently treatment-resistant hypertension from 2000 to 2017.
The researchers found that 1.6% of the patients had been tested for primary aldosteronism. The likelihood of screening was increased with an index visit to a nephrologist or endocrinologist compared with primary care (risk ratios, 2.05 and 2.48, respectively). There was a noted association between testing and an increased likelihood of initiating mineralocorticoid receptor antagonist (MRA) therapy (risk ratio, 4.10) and with better blood pressure control over time.
“The consequences of underestimating primary aldosteronism and underuse of MRAs in patients with apparently treatment-resistant hypertension can be significant, potentially increasing morbidity and mortality,” the authors write. “Our results suggest an opportunity to introduce innovative practices to significantly improve provider education and increase testing to improve the management of this high-risk patient population.”
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