Screening and diagnosis trends for primary aldosteronism: a longitudinal nationwide study of 7.8 million people
Authors' conclusion
Despite an increase in PA screening over the past 2 decades, absolute rates remain critically low, falling far short of guideline recommendations, even in high-risk groups. Our findings quantify a major implementation gap between evidence and clinical practice.
Study context
- Population
- All patients with hypertension in Taiwan, 2001–2022
- Participants
- 7.8 million patients
- Outcome
- Annual PA screening and diagnosis rates among the hypertensive population
- Follow-up
- 2001–2022
Methodological detailsnationwide, national health insurance database
- Nationwide
- National health insurance database
Main finding
As reported in the abstract
- Received primary aldosteronism (PA) screening during the study period
- 4.4%
- Annual PA screening rate in 2001
- 0.26%
- Annual PA screening rate in 2022
- 0.75%
- Increase in annual PA screening rate 2001 to 2022
- P < .001
- Diagnostic yield of PA: slight decrease over time, fluctuating between
- 8.0% and 6.7%
- Decrease in diagnostic yield over time
- P = .006
Observational data: associations, not effects.
Further findings
Screening in high-risk subgroups · 2022
- Resistant hypertension screened
- 1.0%
- Early-onset hypertension screened
- 3.2%
- Hypokalemia screened
- 3.6%
Original publication
Screening and diagnosis trends for primary aldosteronism: a longitudinal nationwide study of 7.8 million people. Eur J Endocrinol. Published 27 July 2026. doi:10.
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