Are We Only Detecting the Tip of the Iceberg? A Nationwide Study on Primary Aldosteronism with up to 8-Year Follow-up

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Background: Long-term follow-up studies on primary aldosteronism (PA) are lacking. Objective: We aim to review results of diagnostic procedures and histopathology for patients diagnosed during 2012–2016 in Iceland, compare unilateral (UD) and bilateral disease (BD) and assess treatment response. Methods: Thirty-two patients aged 28–88 were diagnosed and treated according to guidelines. Results: The majority had BD. Everyone needed potassium supplementation at case detection. We saw a reduction in systolic blood pressure (p < .001, both groups), antihypertensive agents (p = .002 UD and p = .04 BD) and potassium supplementation (p < .001, both groups). Conclusion: Similar treatment response was seen in both subgroups. Ratio of hypokalemia and number of cases indicates severe PA underdiagnosis in Iceland.

Original languageEnglish
Pages (from-to)104-112
Number of pages9
JournalEndocrine Research
Issue number3-4
Early online date29 Apr 2022
Publication statusPublished - 29 Apr 2022

Bibliographical note

Funding Information:
This work was supported by the Landspitali University Hospital Research Fund under Grant number [B-2020-008]. The authors want to thank Ubaldo Benitez Hernandez, statistician and natural scientist at LUH, for his help with statistical analysis regarding follow-up, and Gudmundur Sigthorsson, MD, PhD, at LUH for assessing laboratory values.

Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.

Other keywords

  • Primary aldosteronism
  • adrenal venous sampling
  • adrenalectomy
  • potassium supplementation
  • saline infusion test
  • Follow-Up Studies
  • Humans
  • Adrenalectomy/methods
  • Hyperaldosteronism/diagnosis
  • Aldosterone
  • Retrospective Studies
  • Antihypertensive Agents
  • Potassium


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