BACKGROUND: Despite hyperaldosteronism being suggested as predisposing to arrhythmias, the relationship between atrial fibrillation and primary aldosteronism remains uncertain. Therefore, we tested the hypothesis that atrial fibrillation is a presentation of primary aldosteronism in hypertensive patients with unexplained atrial fibrillation. DESIGN AND METHODS: The Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) Study recruited consecutive patients with atrial fibrillation and an unambiguous diagnosis of arterial hypertension at three referral centers for hypertension. RESULTS: In a cohort entailing 411 atrial fibrillation patients, we identified 18% (age 61 ± 11 years; 32% women), who showed no known cause of the arrhythmia. A thorough diagnostic work-up allowed us to identify primary aldosteronism in 73 of these patients (i.e. 42%) [95% confidence interval (CI) 31.8-53.9]. Subtyping of primary aldosteronism demonstrated that surgically curable forms of primary aldosteronism accounted for 48% of the cases (95% CI 31.9-65.2). The high prevalence of primary aldosteronism was confirmed at sensitivity analyses. CONCLUSION: These results provided compelling evidence that primary aldosteronism is highly prevalent in hypertensive patients with unexplained atrial fibrillation. Accordingly, they suggest that patients with no identifiable cause of the arrhythmia should be screened for primary aldosteronism to identify those who can be cured or markedly improved with target treatment

Atrial fibrillation as presenting sign of primary aldosteronism. Results of the prospective appraisal on the prevalence of primary aldosteronism in hypertensive (papphy) study / Seccia, Teresa M; Letizia, Claudio; Muiesan, Maria L; Lerco, Silvia; Cesari, Maurizio; Bisogni, Valeria; Petramala, Luigi; Maiolino, Giuseppe; Volpin, Roberta; Rossi, Gian Paolo. - In: JOURNAL OF HYPERTENSION. - ISSN 0263-6352. - 38:2(2020), pp. 332-339. [10.1097/HJH.0000000000002250]

Atrial fibrillation as presenting sign of primary aldosteronism. Results of the prospective appraisal on the prevalence of primary aldosteronism in hypertensive (papphy) study

Letizia, Claudio;Petramala, Luigi;
2020

Abstract

BACKGROUND: Despite hyperaldosteronism being suggested as predisposing to arrhythmias, the relationship between atrial fibrillation and primary aldosteronism remains uncertain. Therefore, we tested the hypothesis that atrial fibrillation is a presentation of primary aldosteronism in hypertensive patients with unexplained atrial fibrillation. DESIGN AND METHODS: The Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) Study recruited consecutive patients with atrial fibrillation and an unambiguous diagnosis of arterial hypertension at three referral centers for hypertension. RESULTS: In a cohort entailing 411 atrial fibrillation patients, we identified 18% (age 61 ± 11 years; 32% women), who showed no known cause of the arrhythmia. A thorough diagnostic work-up allowed us to identify primary aldosteronism in 73 of these patients (i.e. 42%) [95% confidence interval (CI) 31.8-53.9]. Subtyping of primary aldosteronism demonstrated that surgically curable forms of primary aldosteronism accounted for 48% of the cases (95% CI 31.9-65.2). The high prevalence of primary aldosteronism was confirmed at sensitivity analyses. CONCLUSION: These results provided compelling evidence that primary aldosteronism is highly prevalent in hypertensive patients with unexplained atrial fibrillation. Accordingly, they suggest that patients with no identifiable cause of the arrhythmia should be screened for primary aldosteronism to identify those who can be cured or markedly improved with target treatment
2020
aldosterone, atrial fibrillation, blood pressure, hypertension
01 Pubblicazione su rivista::01a Articolo in rivista
Atrial fibrillation as presenting sign of primary aldosteronism. Results of the prospective appraisal on the prevalence of primary aldosteronism in hypertensive (papphy) study / Seccia, Teresa M; Letizia, Claudio; Muiesan, Maria L; Lerco, Silvia; Cesari, Maurizio; Bisogni, Valeria; Petramala, Luigi; Maiolino, Giuseppe; Volpin, Roberta; Rossi, Gian Paolo. - In: JOURNAL OF HYPERTENSION. - ISSN 0263-6352. - 38:2(2020), pp. 332-339. [10.1097/HJH.0000000000002250]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1346846
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