title: Primary aldosteronism: from case detection to histopathology with up to 6 years of follow-up.
abstract: The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long-term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007-2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling. Patients with unilateral disease were offered treatment with adrenalectomy. A total of 33 patients were diagnosed with PA during the study period: 17 patients with bilateral disease and 16 with unilateral disease. Results from salt loading test were positive in 90% of patients. In patients with adenoma, 36% were responsive on their positional test and computed tomography scan showed a nodule in 73%. All patients with unilateral disease had a lateralization index ≥3. After surgery, patients had lower systolic blood pressure (P<.001) and number of hypertensive medications (P<.01).
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
authors.forename: Gudbjörg
authors.initials: G
authors.lastname: Jonsdottir
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Jon
authors.initials: J
authors.lastname: Gudmundsson
authors.affiliation: Department of Surgery, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Gudjon
authors.initials: G
authors.lastname: Birgisson
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.|Division of Endocrinology, Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Helga Agusta
authors.initials: HA
authors.lastname: Sigurjonsdottir
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000311:Adrenal Glands / Q000098:blood supply; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis* / Q000601:surgery; D006965:Hyperplasia; D006973:Hypertension / Q000188:drug therapy; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed