Incidence of Adrenal Masses Eventually Discovered in Patients Screened for Primary Aldosteronism
Authors' conclusion
Among patients screened for PA but without prior or subsequent directed adrenal imaging, 1 in 14 were later found to have an adrenal mass on imaging done for other indications. Given the impact on pretest probability for endocrine hypertension and further investigation steps, routine adrenal imaging might be considered whenever PA suspicion is high.
Study context
- Population
- Patients with hypertension and any aldosterone-renin ratio (ARR) measurement, 2012 to 2019, without pre-ARR imaging; provincial administrative and clinical radiology and biochemistry databases, Alberta, Canada1,462 imaged after ARR
- Participants
- 6,942 patients
- Outcome
- Scans showing adrenal mass
Main finding
As reported in the abstract
Incidence rate estimate of scans showing adrenal mass
7.2%
5.6–9.2%
Adrenal mass size, median
1.4 cm
1.1–2.3
Number needed to screen to detect an adrenal mass without a priori indication for adrenal imaging
14
11–18
Observational data: associations, not effects.
Further findings
- Had imaging at some point after ARR
- 1462 (21%)
- Imaging for indications unrelated to hypertension/adrenal
- 912 (62.4%)
- Time from ARR to imaging, median
- 771 days (69-1577)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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