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International Journal of Hypertension
Volume 2011, Article ID 162804, 7 pages
http://dx.doi.org/10.4061/2011/162804
Review Article

Changes in the Perceived Epidemiology of Primary Hyperaldosteronism

S. C. Nefrologia e Dialisi, Azienda Ospedaliera di Perugia, S. Andrea delle Fratte, 06129 Perugia, Italy

Received 9 March 2011; Revised 9 May 2011; Accepted 13 June 2011

Academic Editor: Zafar Israili

Copyright © 2011 Riccardo Maria Fagugli and Chiara Taglioni. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Primary aldosteronism has been considered a rare disease in the past years, affecting 1% of the hypertensive population. Subsequently, growing evidence of its higher prevalence is present in literature, although the estimates of disease range from 5 up to 20%, as in type 2 diabetes and resistant hypertension. The main reasons for these variations are associated with the selection of patients and diagnostic procedures. If we consider that hypertension is present in about 20% of the adult population, primary aldosteronism can no longer be considered a rare disease. Patients with primary aldosteronism have a high incidence of cardiovascular, cerebrovascular and kidney complications. The identification of these patients has therefore a practical value on therapy, and to control morbidities derived from vascular damage. The ability to identify the prevalence of a disease depends on the number of subjects studied and the methods of investigation. Epidemiological studies are affected by these two problems: there is not consensus on patients who need to be investigated, although testing is recommended in subjects with resistant hypertension and diabetes. The question of how to determine aldosterone and renin levels is open, particularly if pharmacological wash-out is difficult to perform because of inadequate blood pressure control.