Blood pressure · 2026
Hypertension action bundle including training of healthcare professionals to improve the detection of primary aldosteronism: a cohort study.
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Franko Benoit, Jost Sandra, Moutel Sandrine, Rey Isabelle, Collet Sylvain, Delory Tristan
Аннотация
OBJECTIVE: As a blood pressure clinic, we have developed a hypertension action bundle including a training programme to facilitate secondary hypertension screening, delivered during three phases: P1 (2016-2018): for hospital practitioners; P2 (2019-2021): for practitioners working outside of hospitals; P3 (2022-2024): consolidation phase. We hypothesised that a training programme could enhance diagnosis of primary aldosteronism (PA).
DESIGN AND METHOD: This study included patients diagnosed with PA between 2016 and 2024. The primary objective was to investigate the incidence of PA diagnosis across three distinct time periods. In addition, we investigated patient origin, reason for consultation and clinical-biological profile, with a view to gaining insight into the diagnostic process.
RESULTS: A total of 110 PA patients were diagnosed with PA. The annual incidence of primary aldosteronism (PA) per 1000 consultations increased significantly from 1.2 in P1 to 2.64 in P2 (Odds Ratio P1-P2: 2.2 [95CI, 1.2-4.1]) and 4.31 in P3 (Odds Ratio P2-P3: 1.6 [95CI, 1.1-2.4]). This increase can be primarily attributed to enhanced screening by general practitioners and cardiologists. PA screening indications had also evolved over time, shifting from hypokalaemia and hypertension with target organ damage in P2, to pre-eclampsia, refractory hypertension or hypertension in young patients in P3. There was little to no change in patient's clinic-biological profile between periods.
CONCLUSION: The hypertension action bundling including training of physicians in the management of high blood pressure has resulted in significant advancements in the diagnosis and management of PA, through the identification of less common hypertension profiles.
DESIGN AND METHOD: This study included patients diagnosed with PA between 2016 and 2024. The primary objective was to investigate the incidence of PA diagnosis across three distinct time periods. In addition, we investigated patient origin, reason for consultation and clinical-biological profile, with a view to gaining insight into the diagnostic process.
RESULTS: A total of 110 PA patients were diagnosed with PA. The annual incidence of primary aldosteronism (PA) per 1000 consultations increased significantly from 1.2 in P1 to 2.64 in P2 (Odds Ratio P1-P2: 2.2 [95CI, 1.2-4.1]) and 4.31 in P3 (Odds Ratio P2-P3: 1.6 [95CI, 1.1-2.4]). This increase can be primarily attributed to enhanced screening by general practitioners and cardiologists. PA screening indications had also evolved over time, shifting from hypokalaemia and hypertension with target organ damage in P2, to pre-eclampsia, refractory hypertension or hypertension in young patients in P3. There was little to no change in patient's clinic-biological profile between periods.
CONCLUSION: The hypertension action bundling including training of physicians in the management of high blood pressure has resulted in significant advancements in the diagnosis and management of PA, through the identification of less common hypertension profiles.