Cardiovascular Endocrinology

SAT-281 - Screening and Diagnosis Trends for Primary Aldosteronism: A Longitudinal Nationwide Cohort Study of 7.8 Million People

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Location: ENDOExpo; Poster Floor

Abstract Poster Presenter(s)

CT

Cheng-Hsuan Tsai, MD (he/him/his)

Brookline, MA, United States

Co-Author(s)

YC

Yu-Ching Chang, MD

National Taiwan University Hospital Hsin-Chu Branch
Hsin-Chu, Taiwan (Republic of China)
CC

Chin-Chen Chang, MD

National Taiwan University Hospital
Taipei, Taiwan (Republic of China)
SP

Stefanie Parisien-La Salle, MD

Centre Hospitalier de l'Université de Montréal
Montreal, Quebec, Canada
JB

Jenifer M. Brown, MD

Cardiovascular Medicine
Brigham and Women’s Hospital
Boston, Massachusetts, United States
AV

Anand Vaidya, MD (he/him/his)

MD
Mass General Brigham, Harvard Medical School
Boston, MA, United States
VW

Vin-Cent Wu, MD, PhD

Professor
National Taiwan University Hospital
Taipei, Taiwan (Republic of China)

Senior Author/Primary Investigator(s)

YL

Yen-Hung Lin, MD, PhD

Professor
National Taiwan University Hospital
Taipei, Taiwan (Republic of China)

Background: Primary aldosteronism (PA) is a common, treatable cause of hypertension for which screening is widely recommended but rarely performed in clinical practice. However, real-world screening and diagnosis patterns across the entire hypertensive population remain unknown. This study aimed to delineate the 22-year state of nationwide PA screening and diagnosis rates among all hypertensive population in Taiwan

Methods: In this nationwide retrospective cohort study from 2001 to 2022, we identified all patients with hypertension using a national health insurance database. We calculated annual PA screening and diagnosis rates, with particular focus on high-risk subgroups, including patients with resistant hypertension, early-onset hypertension, hypokalemia, and other comorbidities warranting screening.

Results: Among 7.8 million patients with hypertension, a total of 4.4% received PA screening during the study period. The annual PA screening rate increased from 0.26% in 2001 to 0.75% in 2022 (p < 0.001) yet remained markedly low. In 2022, only 1.0% of patients with resistant hypertension, 3.0% with early-onset hypertension, and 3.6% with hypokalemia underwent screening. The diagnostic yield of PA showed a slight decrease over time, fluctuating between 8.0% and 6.7% (p = 0.006).

Conclusions: Despite an increase in PA screening over the past two decades, absolute rates remain critically low, falling far short of guideline recommendations, especially in high-risk groups. Our findings quantify a major implementation gap between evidence and clinical practice. As international guidelines are shifting towards broader and simpler screening protocols, there is an urgent need to improve the detection of this common and actionable condition.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*