Aldosteronismo primario: una enfermedad subdiagnosticada

Abstract

Introduction: Primary aldosteronism is a clinical entity of growing interest in endocrinology and cardiology, as it is the most important and curable cause of resistant arterial hypertension. It is estimated that its prevalence worldwide ranges between 3 and 14% in the general population and can rise to 22 and 29% in patients with hypertension and resistant hypertension, respectively. Development: Currently, studies show that the detection of primary aldosteronism in the community is below its prevalence rate. One study showed a detection rate of 1.6% compared to a prevalence of 12% in American veterans with resistant hypertension. This underdiagnosis is attributed to several factors, such as the absence of easily identifiable specific characteristics, the lack of knowledge about the pathology, and the scarce information on recommendations for its detection in normotensive and hypertensive individuals, either within primary or secondary care settings. Conclusion: The masking of this entity is due to the lack of expertise of health professionals in identifying patients with primary aldosteronism, either due to the complexity of its clinical presentation and the lack of specific symptoms or due to insufficient knowledge about it. In addition, the scarce scientific evidence on standardized and/or internationalized protocols in the diagnostic management of the disease can also delay its recognition in daily clinical practice.