Abstract: SA-PO0470
Following Primary Aldosteronism Screening: Challenges of Controlling Persistent Hypertension in Real-World Clinical Practice
Session Information
- CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Treves, Nir, AstraZeneca, Israel, Kfar Saba, Israel
- Leiba, Adi, Joyce and Irving Goldman School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Berenheim, Mai, AstraZeneca, Israel, Kfar Saba, Israel
- Yahalom, Roni, AstraZeneca, Israel, Kfar Saba, Israel
- Admon, Meytal, AstraZeneca, Israel, Kfar Saba, Israel
- Livnat, Idit, AstraZeneca, Israel, Kfar Saba, Israel
- Yarden, Adva, AstraZeneca, Israel, Kfar Saba, Israel
- Gross, Victor, Meuhedet Health Service, Tel Aviv, Israel
- Chodick, Gabriel, School of Public Health, Gray Faculty of Medical&Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Zacay, Galia, Meuhedet Health Service, Tel Aviv, Israel
Background
Hypertension (HTN) drives kidney disease progression. Despite interventions, many patients fail to achieve blood pressure (BP) control. Various guidelines recommend primary aldosteronism (PA) screening. While mineralocorticoid receptor antagonists (MRAs) target PA, negative-test patients require empirical intensive anti-HTN therapy. This analysis characterizes two uncontrolled HTN populations: PA patients on MRAs and those with negative PA tests receiving new anti-HTN therapy.
Methods
This study utilized Israeli Meuhedet database identifying aldosterone and renin tests in adults >18 years with BP≥140/90 mmHg and BP≥130/80. PA was defined as ARR≥2.5 ng/µIU, renin≤8.2 µIU/mL and aldosterone≥10.0 ng/mL. Positive patients for PA were included if they initiated new MRA treatment (MRA group). Negative patients for PA were included if they initiated new anti-HTN treatment (Anti-HTN group). Follow up started on the day therapy initiated, with a maximal follow up of 3 years. Outcomes included uncontrolled HTN proportions and sustained uncontrolled BP, defined as two consecutive measurements above target with 90-day intervals. BP analysis used boxplots with median systolic BP (SBP).
Results
The MRA group included 109 patients and the anti-HTN group 1108 patients with a mean age of 63.6 and 59.9 years respectively. ~50% of recorded measurements were above 140/90 mmHg and ~75% were above 130/80 mmHg. Thirty-five percent had sustained uncontrolled HTN. Boxplots show that uncontrolled HTN is prevalent throughout all follow-up periods.
Conclusion
This analysis reveals a treatment gap in HTN management among patients tested for PA regardless of test results. Despite targeted PA treatment and intensified anti-HTN therapy, considerable proportion of patients remain inadequately controlled, highlighting a substantial unmet clinical burden.
Funding
- Commercial Support – AstraZeneca