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March 4, 2026EpidemiologiaOpen Access

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

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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

Key result

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.

Authors

CSChristos SavvidisIppokrateio General Hospital of ThessalonikiHMHaralampos MilionisUniversity of IoanninaAPArgyro Pachi

Discussion

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Overview

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
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