A Prospective Study of the Prevalence of Primary Aldosteronism in 1,125 Hypertensive Patients
Gian Paolo Rossi, MD, FACC, FAHA*,
Giampaolo Bernini, MD,
Chiara Caliumi, MD,
Giovambattista Desideri, MD,
Bruno Fabris, MD,
Claudio Ferri, MD,
Chiara Ganzaroli, MD,
Gilberta Giacchetti, MD,
Claudio Letizia, MD,
Mauro Maccario, MD,
Francesca Mallamaci, MD,
Massimo Mannelli, MD,
Mee-Jung Mattarello, MD,
Angelica Moretti, MD,
Gaetana Palumbo, MD,
Gabriele Parenti, MD,
Enzo Porteri, MD,
Andrea Semplicini, MD, FAHA,
Damiano Rizzoni, MD,
Ermanno Rossi, MD,
Marco Boscaro, MD,
Achille Cesare Pessina, MD, PhD,
Franco Mantero, MD PAPY Study Investigators
For a list of author affiliations, please see the Appendix
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Figure 1 This flowchart shows the protocol for the recruitment and investigation of the PAPY (PA Prevalence in Hypertensives) study population. AHA = American Heart Association; APA = aldosterone-producing adenoma; ARR = aldosterone/renin ratio; AVS = adrenal vein sampling; CT = computed tomography; IHA = idiopathic hyperaldosteronism; LDF = logistic discriminant analysis; MR = magnetic resonance.
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Figure 2 This bar graph shows that a substantial proportion of the patients with APA and IHA did not have hypokalemia (red bars) at the time of presentation. APA = aldosterone-producing adenoma; IHA = idiopathic hyperaldosteronism; PH = primary hypertension.
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Figure 3 This bar graph shows the proportion of patients without PA (white bars), with IHA (red bars), and with APA (black bars) in the patients at the screening test. The proportion of patients with PA caused by both APA and IHA increased significantly (from 7.2% to 19.5%) with the increasing severity of hypertension. APA = aldosterone-producing adenoma; BP = blood pressure; HT = hypertension; IHA = idiopathic hyperaldosteronism; PA = primary aldosteronism; PH = primary hypertension.
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Figure 4 This histogram shows the proportion of PA patients with APA (black bars) and IHA (red bars) by availability of adrenal vein sampling (AVS) in the participating centers. APA = aldosterone-producing adenoma; IHA = idiopathic hyperaldosteronism; PA = primary aldosteronism.
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