ArticleThe Journal of clinical endocrinology and metabolism2024
The Spectrum of Dysregulated Aldosterone Production: An International Human Physiology Study.
Article in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06740838 (Overnight Dexamethasone in Primary Aldosteronism Screening in Patients on Interfering Therapy), which is not on this map. Cited by 29 papers, 1 of them a synthesis that pooled 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.
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.
Overnight Dexamethasone in Primary Aldosteronism Screening in Patients on Interfering Therapy (the ODEPRASC Study)
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- 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
- From bench to bedside: primary aldosteronism revisited.Endocrine connections · 2026Article
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
- Low-renin hypertension in incidental adrenal adenomas and response to aldosterone-targeted therapy: a prospective study.European journal of internal medicine · 2026Article
- Primary aldosteronism.Nature reviews. Disease primers · 2026Review
- Renin-Guided Risk Stratification and Therapy in Hypertension to Reduce Major Adverse Cardiovascular Outcomes.medRxiv : the preprint server for health sciences · 2026Article
- The Burden, Outcomes, and Management of Patients with Aldosterone Dysregulation: A Targeted Literature Review.Advances in therapy · 2026Review
- Hypertensive Disorders of Pregnancy and Primary Aldosteronism.Hypertension (Dallas, Tex. : 1979) · 2026Article
- Unmasking Hormonal Mechanisms of Hypertension in Obesity.JACC. Basic to translational science · 2026Article
- Is It Time to Retire Aldosterone Suppression Testing?American journal of hypertension · 2026Review
- Hypertensive Disorders of Pregnancy and Primary Aldosteronism.medRxiv : the preprint server for health sciences · 2026Article
- Primary aldosteronism beyond laterality: integrating subtype assignment with outcome-oriented risk stratification.Frontiers in endocrinology · 2026Review
- Subclinical primary aldosteronism: toward a conceptual framework linking primary aldosteronism and low-renin hypertension.Frontiers in endocrinology · 2026Review
- NT-proBNP and its association with autonomous aldosterone production in primary aldosteronism.Therapeutic advances in endocrinology and metabolism · 2026Article
- Subclinical primary aldosteronism.Archives of endocrinology and metabolism · 2025Review
- Unmasking Hormonal Mechanisms of Hypertension in Obesity.medRxiv : the preprint server for health sciences · 2025Article
- Baxdrostat for uncontrolled and resistant hypertension: rationale and design of the Phase 3 clinical trials BaxHTN, BaxAsia, and Bax24.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Article
- Overnight Dexamethasone in Primary Aldosteronism Screening in Patients on Interfering Therapy (ODEPRASC): A Diagnostic Interpretability Study Protocol.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Subclinical Primary Aldosteronism Is Characterized by Maladaptive Natriuretic Peptide and Adrenal Hormonal Physiology.The Journal of clinical endocrinology and metabolism · 2025Observational
- Glucocorticoids: The culprit behind metabolic disorders in primary Aldosteronism? A narrative review.Journal of clinical & translational endocrinology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 3 countries.
Funding
Abstract
contextPrimary aldosteronism is a form of low-renin hypertension characterized by dysregulated aldosterone production.
objectiveTo investigate the contributions of renin-independent aldosteronism and ACTH-mediated aldosteronism in individuals with a low-renin phenotype representing the entire continuum of blood pressure. DESIGN/
participantsHuman physiology study of 348 participants with a low-renin phenotype with severe and/or resistant hypertension, hypertension with hypokalemia, elevated blood pressure and stage I/II hypertension, and normal blood pressure.
setting4 international centers. INTERVENTIONS/
main outcome measuresThe saline suppression test (SST) to quantify the magnitude of renin-independent aldosteronism; dexamethasone suppression and ACTH-stimulation tests to quantify the magnitude of ACTH-mediated aldosteronism; adrenal venous sampling to determine lateralization.
resultsThere was a continuum of nonsuppressible and renin-independent aldosterone production following SST that paralleled the magnitude of the blood pressure continuum and transcended conventional diagnostic thresholds. In parallel, there was a full continuum of ACTH-mediated aldosteronism wherein post-SST aldosterone levels were strongly correlated with ACTH-stimulated aldosterone production (r = 0.75, P < .0001) and nonsuppressible aldosterone production postdexamethasone (r = 0.40, P < .0001). Beyond participants who met the criteria for primary aldosteronism (post-SST aldosterone of ≥10 ng/dL or ≥277 pmol/L), the continuum of nonsuppressible and renin-independent aldosterone production persisted below this diagnostic threshold, wherein 15% still had lateralizing aldosteronism amenable to surgical adrenalectomy and the remainder were treated with mineralocorticoid receptor antagonists.
conclusionIn the context of a low-renin phenotype, there is a continuum of primary aldosteronism and dysregulated aldosterone production that is prominently influenced by ACTH. A large proportion of individuals with low renin may benefit from aldosterone-directed therapy.
Indexed as
Identifiers
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.