Abstract: FR-PO0374
Rates of Primary Aldosteronism Testing in Patients with Secondary Hypertension in a National Outpatient Nephrology Private Practice Cohort
Session Information
- Hypertension and CVD: Clinical - 2
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Rivera-Ramirez, Idalis, Brown University, Providence, Rhode Island, United States
- Kruger Gomes, Larissa, Nephrology Associates, Inc, East Providence, Rhode Island, United States
Background
Despite primary aldosteronism (PA) being a prevalent cause of secondary hypertension, multiple studies show that physicians continue to under test for this condition. Previous studies show that while primary care physicians test about 1.6% of eligible patients, nephrologists performed slightly better at 4%. In this study, we assessed rates of testing of PA in patients with secondary hypertension in a national cohort of outpatient nephrology private practices consisting of over 800 nephrologists across 19 states.
Methods
We conducted a database search of patients who had a diagnosis of hypertension and continued to have blood pressure above goal while (a) being on 3 antihypertensive medications (including one diuretic) or (b) being on 4 antihypertensive medications of different classes. From this selected cohort, we looked at how many patients were either tested with renin and aldosterone levels or prescribed a potassium-sparing diuretic.
Results
2,400 (1.6%) patients were tested for primary aldosteronism of the total number of patients in the sample. Patients in older age groups (50-59, 60-69, >70) have significantly lower odds of being tested for primary aldosteronism, with the largest discrepancy being the >70 year olds (odds ratio [OR] = 0.21, p-value = 0, confidence interval [CI] = 0.04 to 0.07). Males have 11% lower odds of being tested than females (OR = 0.89, p-value = 0.007, CI = 0.82 to 0.97). Compared to married people, single people had 10% lower odds of being tested (OR = 0.89, p-value = 0.028, CI = 0.82 to 0.99). When evaluating differences in testing across spoken languages, those that fell under the ‘other’ category had 41% lower odds of being tested compared to English speakers (OR = 0.59, p-value = 0.045, CI 0.36 to 0.99).
Conclusion
In this cohort of outpatient nephrology patients, the rates of testing of PA in patients with secondary hypertension remained low at 1.6%. Significant disparities in testing were observed across age, sex, marital status, and language groups. These findings highlight the need for increased education surrounding guideline-recommended practices to improve PA screening among patients with secondary hypertension.