scholarly journals Prevalence of primary aldosteronism in primary care: a cross-sectional study

2018 ◽  
Vol 68 (667) ◽  
pp. e114-e122 ◽  
Author(s):  
Sabine C Käyser ◽  
Jaap Deinum ◽  
Wim JC de Grauw ◽  
Bianca WM Schalk ◽  
Hans JHJ Bor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Cross Sectional Study ◽  
Plasma Aldosterone ◽  
Infusion Test ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Aldosterone To Renin Ratio

BackgroundPrimary aldosteronism (PA) is the most frequent cause of secondary hypertension. Reported prevalences of PA vary considerably because of a large heterogeneity in study methodology.AimTo examine the proportion of patients with PA among patients with newly diagnosed, never treated hypertension.Design and settingA cross-sectional study set in primary care.MethodGPs measured aldosterone and renin in adult patients with newly diagnosed, never treated hypertension. Patients with elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration underwent a saline infusion test to confirm or exclude PA. The source population was meticulously assessed to detect possible selection bias.ResultsOf 3748 patients with newly diagnosed hypertension, 343 patients were screened for PA. In nine out of 74 patients with an elevated aldosterone-to-renin ratio and increased plasma aldosterone concentration the diagnosis of PA was confirmed by a saline infusion test, resulting in a prevalence of 2.6% (95% confidence interval = 1.4 to 4.9). All patients with PA were normokalaemic and 8 out of 9 patients had sustained blood pressure >150/100 mmHg. Screened patients were younger (P<0.001) or showed higher blood pressure (P<0.001) than non-screened patients.ConclusionIn this study a prevalence of PA of 2.6% in a primary care setting was established, which is lower than estimates reported from other primary care studies so far. This study supports the screening strategy as recommended by the Endocrine Society Clinical Practice Guideline. The low proportion of screened patients (9.2%), of the large cohort of eligible patients, reflects the difficulty of conducting prevalence studies in primary care clinical practice.

scholarly journals Is the plasma aldosterone-to-renin ratio associated with blood pressure response to treatment in general practice?

2018 ◽  
Vol 36 (2) ◽  
pp. 154-161
Author(s):  
Sabine C Käyser ◽  
Bianca W M Schalk ◽  
Wim J C de Grauw ◽  
Tjard R Schermer ◽  
Reinier P Akkermans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Antihypertensive Treatment ◽  
Blood Pressure Response ◽  
Pressure Response ◽  
Plasma Aldosterone ◽  
Target Blood Pressure ◽  
Response To Treatment ◽  
Newly Diagnosed ◽  
Aldosterone To Renin Ratio

Abstract Background Individualized antihypertensive treatment based on specific biomarkers such as renin may lead to more effective blood pressure control in patients with newly diagnosed essential hypertension. Recent studies suggested that the plasma aldosterone-to-renin ratio (ARR) may also be a candidate predictor for this purpose. Objective To assess whether the ARR is associated with the blood pressure response to antihypertensive treatment in patients with newly diagnosed hypertension. Methods In this prospective cohort study in primary care, we determined the ARR in patients with newly diagnosed hypertension prior to starting treatment. Treatment was categorized in five groups: no medication, use of angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker, use of calcium channel blocker, use of diuretic, or use of beta blocker. We examined the relation between the ARR and blood pressure response within 1 year of treatment, taking into account the type of antihypertensive treatment and adjusting for gender, age, baseline blood pressure, and comorbidity. Results Out of 304 patients, we used 947 measurements (727 no medication, 220 medication) for analysis. There was no association between the ARR and the response in blood pressure, and this applied to each treatment group. Target blood pressure, defined as systolic blood pressure &lt;140 mmHg, was reached in 31% of patients. There was no association between the ARR and reaching target blood pressure (OR 1.002, 95% CI 0.983–1.022). Conclusion The ARR is not associated with the response in blood pressure within 1 year of antihypertensive treatment in primary care.

scholarly journals Visit patterns at primary care centres and individual blood pressure level – a cross-sectional study

2019 ◽  
Vol 37 (1) ◽  
pp. 53-59 ◽  
Author(s):  
H. Ödesjö ◽  
S. Adamsson Eryd ◽  
S. Franzén ◽  
P. Hjerpe ◽  
K. Manhem ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Level ◽  
Cross Sectional Study ◽  
Pressure Level ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Fatores Associados a Tensão Arterial Não Controlada em Pessoas com Diabetes Tipo 2 Seguidas nos Cuidados de Saúde Primários em Portugal

2017 ◽  
Vol 30 (3) ◽  
pp. 197 ◽  
Author(s):  
Inês Rosendo ◽  
Luiz Miguel Santiago ◽  
Margarida Marques
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Patients

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.

scholarly journals Influence of ethnicity on acceptability of method of blood pressure monitoring: a cross-sectional study in primary care

2016 ◽  
Vol 66 (649) ◽  
pp. e577-e586 ◽  
Author(s):  
Sally Wood ◽  
Sheila M Greenfield ◽  
M Sayeed Haque ◽  
Una Martin ◽  
Paramjit S Gill ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Monitoring ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Pressure Monitoring ◽  
Cross Sectional
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