Validation of a novel risk stratification model for primary aldosteronism

Primary aldosteronism (PA) is an under-diagnosed cause of resistant hypertension. In this study, we validated a PA risk stratification model in an independent cohort. Patients screened for PA were identified and risk scores were calculated for each patient. The predicted and observed proportions of PA-positive patients at each risk score were assessed and performance, accuracy, and cut-point analyses were calculated. Among 652 patients screened, 13% were positive for PA. Rates of PA increased significantly (p < 0.001) with increase in risk score and varied from 0% (1 point) to 29% (9 points). The optimal cut-point was 6. The model showed moderate performance at predicting the risk of PA, with AUC of 0.66 (95% CI 0.60-0.72), sensitivity of 0.57, and Brier statistic of 0.29. A novel scoring system was moderately accurate at predicting the risk of PA in an independent validation cohort and may be clinically useful in identifying patients at elevated risk.