ArticleAnnals of internal medicine2021
Testing for Primary Aldosteronism and Mineralocorticoid Receptor Antagonist Use Among U.S. Veterans : A Retrospective Cohort Study.
Article in Annals of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05925569 (Electronic Alert-Based Computerized Decision Support to Improve Testing For Primary Aldosteronism in Patients With Hypertension), which is not on this map. Cited by 92 papers, 5 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
Who cites it
92 citing papers in PubMed, 5 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- 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
- Guide de pratique clinique en soins de première ligne d'Hypertension Canada pour le diagnostic et le traitement de l'hypertension artérielle chez les adultes.Canadian family physician Medecin de famille canadienGuideline
- Online prediction model for primary aldosteronism in patients with hypertension in Chinese population: A two-center retrospective study.Frontiers in endocrinology · 2022Trial
- Delayed diagnosis, greater disease burden: primary aldosteronism in a Brazilian cohort.Journal of the Endocrine Society · 2026Article
- From bench to bedside: primary aldosteronism revisited.Endocrine connections · 2026Article
- [Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].Anales del sistema sanitario de Navarra · 2026Article
- Performance of Primary Aldosteronism Screening Tests Before Washout of Dihydropyridine Calcium Channel Blockers: An Exploratory Retrospective Study.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- [New developments in endocrinology/diabetology].Innere Medizin (Heidelberg, Germany) · 2026Review
- Blood Pressure Outcomes Among US Veterans Initiating Hypertension Treatment, 2014 to 2023.Circulation. Population health and outcomes · 2026Article
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
- Resistant hypertension, hyperaldosteronism, and the emerging understanding of hypercortisolism.Current opinion in cardiology · 2026Review
- Primary aldosteronism.Nature reviews. Disease primers · 2026Review
- Aldosterone-targeted Therapy after Primary Aldosteronism Testing in Resistant Hypertension: A Nationwide Cohort Study.medRxiv : the preprint server for health sciences · 2026Article
- Broadening Primary Aldosteronism Screening: Alignment Across Contemporary Guidelines.Hypertension (Dallas, Tex. : 1979) · 2026Review
- The Burden, Outcomes, and Management of Patients with Aldosterone Dysregulation: A Targeted Literature Review.Advances in therapy · 2026Review
- Hypertension and primary aldosteronism diagnosis in hospitalized patients: an observation from public hospitals in Victoria, Australia.Endocrine · 2026Observational
- Prevalence of apparent treatment-resistant hypertension and screening rates for primary aldosteronism in an asian ambulatory care setting.Journal of human hypertension · 2026Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPrimary aldosteronism is a common cause of treatment-resistant hypertension. However, evidence from local health systems suggests low rates of testing for primary aldosteronism.
objectiveTo evaluate testing rates for primary aldosteronism and evidence-based hypertension management in patients with treatment-resistant hypertension.
designRetrospective cohort study.
settingU.S. Veterans Health Administration.
participantsVeterans with apparent treatment-resistant hypertension ( MEASUREMENTS: Rates of primary aldosteronism testing (plasma aldosterone-renin) and the association of testing with evidence-based treatment using a mineralocorticoid receptor antagonist (MRA) and with longitudinal systolic BP.
results4277 (1.6%) patients who were tested for primary aldosteronism were identified. An index visit with a nephrologist (hazard ratio [HR], 2.05 [95% CI, 1.66 to 2.52]) or an endocrinologist (HR, 2.48 [CI, 1.69 to 3.63]) was associated with a higher likelihood of testing compared with primary care. Testing was associated with a 4-fold higher likelihood of initiating MRA therapy (HR, 4.10 [CI, 3.68 to 4.55]) and with better BP control over time. LIMITATIONS: Predominantly male cohort, retrospective design, susceptibility of office BPs to misclassification, and lack of confirmatory testing for primary aldosteronism.
conclusionIn a nationally distributed cohort of veterans with apparent treatment-resistant hypertension, testing for primary aldosteronism was rare and was associated with higher rates of evidence-based treatment with MRAs and better longitudinal BP control. The findings reinforce prior observations of low adherence to guideline-recommended practices in smaller health systems and underscore the urgent need for improved management of patients with treatment-resistant hypertension. PRIMARY FUNDING SOURCE: National Institutes of Health.
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What OpenQuestion holds
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.