ArticleAnnals of internal medicine2020
The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study.
Article in Annals of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 313 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Electronic Alert-Based Computerized Decision Support to Improve Testing For Primary Aldosteronism in Patients With Hypertension: ALERT-PA
Resident Doctor, Master Degree Candidate
Overnight Dexamethasone in Primary Aldosteronism Screening in Patients on Interfering Therapy (the ODEPRASC Study)
Steroids-Based Screening for Primary Aldosteronism
Who cites it
313 citing papers in PubMed, 9 syntheses or guidelines pooled it, 576 citations in OpenAlex.
- Baxdrostat in Resistant and Uncontrolled Hypertension: A Systematic Review and Meta-Analysis.Cardiovascular drugs and therapy · 2026Pooled it
- Efficacy and safety of baxdrostat add-on in uncontrolled and resistant hypertension: a systematic review and meta-analysis of randomized controlled trials with GRADE certainty-of-evidence assessment.Naunyn-Schmiedeberg's archives of pharmacology · 2026Pooled it
- Biochemical and renal-metabolic profiles distinguishing primary aldosteronism from essential hypertension: a systematic review and meta-analysis with implications for endocrine hypertension screening.Frontiers in endocrinology · 2026Pooled it
- Clinical value of CXCR4-targeted PET-CT in primary aldosteronism: a systematic review and meta-analysis.European journal of nuclear medicine and molecular imaging · 2025Pooled it
- Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.Canadian family physician Medecin de famille canadien · 2025Guideline
- Guideline
- Hypertension Canada guideline for the diagnosis and treatment of hypertension in adults in primary care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Guideline
- Primary Aldosteronism and Risk of Cardiovascular Outcomes: Genome-Wide Association and Mendelian Randomization Study.Journal of the American Heart Association · 2024Pooled it
- Time to Benefit of Surgery vs Targeted Medical Therapy for Patients With Primary Aldosteronism: A Meta-analysis.The Journal of clinical endocrinology and metabolism · 2024Pooled it
- No Evidence of QTc Interval Prolongation With Baxdrostat Treatment: Concentration-QTc Modeling Assessment.Pharmacology research & perspectives · 2025Trial
- First-in-human study evaluating safety, pharmacokinetics, and pharmacodynamics of lorundrostat, a novel and highly selective aldosterone synthase inhibitor.Clinical and translational science · 2024Trial
- Gender Differences in Cardiac Organ Damage in Arterial Hypertension: Assessing the Role of Drug Nonadherence.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2024Trial
- Sex-dependent modulation of T and NK cells and gut microbiome by low sodium diet in patients with primary aldosteronism.Frontiers in immunology · 2024Trial
- Early mineralocorticoid receptor antagonism for end-organ protection in hypertension: Implications for disparities and rethinking the timing paradigm.Dialogues in health · 2026Review
- Aldosterone-Producing Lesions HarboringHypertension (Dallas, Tex. : 1979) · 2026Article
- Potential under-recognition of primary aldosteronism in young adults with hypertension.Journal of human hypertension · 2026Article
- Optimizing adrenal vein sampling interpretation for primary aldosteronism subtyping.Endocrine · 2026Article
- Comparative Efficacy of Treatments for Resistant or Uncontrolled Hypertension: A Network Meta-Analysis of Randomized Trials.JACC. Advances · 2026Article
- Delayed diagnosis, greater disease burden: primary aldosteronism in a Brazilian cohort.Journal of the Endocrine Society · 2026Article
- The 2025 AHA/ACC Hypertension Guidelines: Key Updates, Historical Context, and Clinical Implications.Current cardiology reports · 2026Review
253 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPrimary aldosteronism is a nonsuppressible renin-independent aldosterone production that causes hypertension and cardiovascular disease.
objectiveTo characterize the prevalence of nonsuppressible renin-independent aldosterone production, as well as biochemically overt primary aldosteronism, in relation to blood pressure.
designCross-sectional study.
setting4 U.S. academic medical centers.
participantsParticipants with normotension ( MEASUREMENTS: Participants completed an oral sodium suppression test, regardless of aldosterone or renin levels, as a confirmatory diagnostic for primary aldosteronism and to quantify the magnitude of renin-independent aldosterone production. Urinary aldosterone was measured in participants in high sodium balance with suppressed renin activity. Biochemically overt primary aldosteronism was diagnosed when urinary aldosterone levels were higher than 12 μg/24 h.
resultsEvery blood pressure category had a continuum of renin-independent aldosterone production, where greater severity of production was associated with higher blood pressure, kaliuresis, and lower serum potassium levels. Mean adjusted levels of urinary aldosterone were 6.5 μg/24 h (95% CI, 5.2 to 7.7 μg/24 h) in normotension, 7.3 μg/24 h (CI, 5.6 to 8.9 μg/24 h) in stage 1 hypertension, 9.5 μg/24 h (CI, 8.2 to 10.8 μg/24 h) in stage 2 hypertension, and 14.6 μg/24 h (CI, 12.9 to 16.2 μg/24 h) in resistant hypertension; corresponding adjusted prevalence estimates for biochemically overt primary aldosteronism were 11.3% (CI, 5.9% to 16.8%), 15.7% (CI, 8.6% to 22.9%), 21.6% (CI, 16.1% to 27.0%), and 22.0% (CI, 17.2% to 26.8%). The aldosterone-renin ratio had poor sensitivity and negative predictive value for detecting biochemically overt primary aldosteronism. LIMITATION: Prevalence estimates rely on arbitrary and conventional thresholds, and the study population may not represent nationwide demographics.
conclusionThe prevalence of primary aldosteronism is high and largely unrecognized. Beyond this categorical definition of primary aldosteronism, there is a prevalent continuum of renin-independent aldosterone production that parallels the severity of hypertension. These findings redefine the primary aldosteronism syndrome and implicate it in the pathogenesis of "essential" hypertension. PRIMARY FUNDING SOURCE: National Institutes of Health.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.