Evidence map›Paper›PMID 36827468›Full record

ArticleAmerican journal of hypertension2023

Screening for Primary Aldosteronism Among Hypertensive Adults with Obstructive Sleep Apnea: A Retrospective Population-Based Study.

Gregory L Hundemer, Haris Imsirovic, Tetyana Kendzerska, Anand Vaidya, Alexander A Leung, Gregory A Kline, Rémi Goupil, François Madore, Mohsen Agharazii, Greg Knoll and 1 more

Open access · greenAbstract read
In one paragraph

Article in American journal of hypertension, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

Gregory L HundemerDivision of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0003-3559-3531
Haris ImsirovicICES (formerly Institute for Clinical Evaluative Sciences), Ottawa, Canada.
Tetyana KendzerskaOttawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Anand VaidyaCenter for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Alexander A LeungDivision of Endocrinology and Metabolism, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Gregory A KlineDivision of Endocrinology and Metabolism, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Rémi GoupilDivision of Nephrology, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, Quebec, Canada.
François MadoreDivision of Nephrology, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, Quebec, Canada.
Mohsen AgharaziiDivision of Nephrology, Department of Medicine, CHU de Québec-Université Laval, Quebec City, Quebec, Canada.
Greg KnollDivision of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Manish M SoodDivision of Nephrology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
University of Ottawa · CAHôpital du Sacré-Cœur de Montréal · CAUniversity of Calgary · CABrigham and Women's Hospital · USInstitute for Clinical Evaluative Sciences · CAUniversité Laval · CA

Funding

Unrecognized Primary Aldosteronism as a Pathogenic Mechanism for Chronic Kidney Disease in DiabetesR01DK115392 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI Anand Vaidya · 2018 to 2026
$6.0M
Aldosterone, the Mineralocorticoid Receptor, and Cardiovascular Disease in ObesityR01HL153004 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI VAIDYA, ANAND · 2020 to 2024
$4.4M
NHLBI NIH HHS R01 HL153004NIDDK NIH HHS R01 DK115392NIH HHS R01 DK115392, R01 HL153004, and R01 DK16618
6 · The paper itself

Abstract

backgroundHypertension plus obstructive sleep apnea (OSA) is recommended in some guidelines as an indication to screen for primary aldosteronism (PA), yet prior data has brought the validity of this recommendation into question. Given this context, it remains unknown whether this screening recommendation is being implemented into clinical practice.

methodsWe conducted a population-based retrospective cohort study of all adult Ontario (Canada) residents with hypertension plus OSA from 2009 to 2020 with follow-up through 2021 utilizing provincial health administrative data. We measured the proportion of individuals who underwent PA screening via the aldosterone-to-renin ratio by year. We further examined screening rates among patients with hypertension plus OSA by the presence of concurrent hypokalemia and resistant hypertension. Clinical predictors associated with screening were assessed via Cox regression modeling.

resultsThe study cohort included 53,130 adults with both hypertension and OSA, of which only 634 (1.2%) underwent PA screening. Among patients with hypertension, OSA, and hypokalemia, the proportion of eligible patients screened increased to 2.8%. Among patients ≥65 years with hypertension, OSA, and prescription of ≥4 antihypertensive medications, the proportion of eligible patients screened was 1.8%. Older age was associated with a decreased likelihood of screening while hypokalemia and subspecialty care with internal medicine, cardiology, endocrinology, or nephrology were associated with an increased likelihood of screening. No associations with screening were identified with sex, rural residence, cardiovascular disease, diabetes, or respirology subspecialty care.

conclusionsThe population-level uptake of the guideline recommendation to screen all patients with hypertension plus OSA for PA is exceedingly low.

Indexed as

HyperaldosteronismHypertensionHypokalemiaSleep Apnea, ObstructiveAdultAldosteroneHumansOntarioReninRetrospective StudiesAldosteroneReninaldosteroneConn’s syndromehyperaldosteronismhypertensionprimary aldosteronismscreeningsleep apnea

Identifiers

PMID36827468
PMCPMC10267649
OpenAlexW4321765558

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.