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March 4, 2026EpidemiologiaOpen Access

Primary Hyperaldosteronism: Epidemiology, Diagnosis, and Clinical Associations

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Key result

Primary aldosteronism affects ~10% of hypertensive patients and is linked to increased MACE despite high underdiagnosis.

Why the study?

The prevalence and morbidity of primary aldosteronism are increasingly acknowledged, yet it continues to be underdiagnosed due to limited screening and diagnostic complexity.

Population

133 relevant studies on primary aldosteronism

Design

Narrative review

Authors

CSChristos SavvidisIppokrateio General Hospital of ThessalonikiHMHaralampos MilionisUniversity of IoanninaAPArgyro Pachi

Discussion

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Implication

Warrants routine screening in resistant and young-onset hypertension; reinforces significant cardiovascular morbidity of underdiagnosed primary aldosteronism.

Key Points

  • The aim is to assess the epidemiology and diagnosis of primary hyperaldosteronism (PA), emphasizing underdiagnosis.
  • Conducted a narrative review using PubMed from 2015 to 2025.
  • Selected 133 relevant studies from an initial 971 articles.
  • Focused on prevalence, risk factors, genetics, and diagnostic challenges without treatment studies.
  • PA prevalence is 5–10%, 17.8% in young-onset, and 20–30% in resistant hypertension.
  • Elevated aldosterone–renin ratio (ARR) is the primary screening tool, though it has limitations.
  • Cardiovascular events occurred in 13.6% of patients over 5.8 years, with significant comorbidities observed.

Structured PICO

P
Population
133 studies addressing prevalence, risk factors, comorbidities, genetics, and diagnostic issues of primary aldosteronism

Primary aldosteronism is a common and underdiagnosed cause of secondary hypertension with significant cardiovascular and metabolic morbidity, requiring improved screening and diagnostic protocols.

Cite This Study

Savvidis et al. (2026) studied this question. Primary aldosteronism affects 5-10% of hypertensive patients and causes 13.6% major cardiovascular events at 5.8 years, with high underdiagnosis due to screening challenges.

synapsesocial.com/papers/69a7cd6ed48f933b5eed9cefhttps://doi.org/10.3390/epidemiologia7020032

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Arterial Stiffness Associated With Long-term Major Adverse Cardiac Events in Patients With Primary Aldosteronism2024 · 7 citations
  2. 2Cardiovascular risk in primary aldosteronism2019 · 44 citations
  3. 3Clinical value of sublingual microcirculatory dysfunction for screening for primary aldosteronism in hypertensive patients2025 · 2 citations
  4. 4Successful adrenal vein sampling in primary aldosteronism in an anatomical variant with accessory hepatic vein drainage2025 · 1 citations
  5. 5Confounders of the aldosterone‐to‐renin ratio when used as a screening test in hypertensive patients: A critical analysis of the literature2020 · 17 citations