One in five Australians have high blood pressure - could better screening help them?
CHE RESEARCH BITES
By Maame Esi Woode and Gang Chen
Published: 15 January, 2024
Primary aldosteronism is underdiagnosed in Australia. Yet screening from age 40 is simple, cost-effective and would prevent health complications.
Primary aldosteronism, also known as Conn’s syndrome, is characterised by the overproduction of the hormone aldosterone by the adrenal glands, leading to increased blood pressure and a higher risk of cardio-vascular disease.
It affects 3% to 14% of people with high blood pressure in primary care settings. In Australia, at least 10% of patients with high blood pressure are estimated to are affected - but the actual figure is likely to be higher.
Currently, only patients with very high blood pressure or treatment-resistant hypertension are screened for primary aldosteronism. Yet, screening is simple - it involves being given a blood test followed by a saline solution into a vein. This can be easily done by GPs and other medical practitioners working in the community.
Using a health economic model, Monash researchers Maame Esi Woode and Gang Chen (Centre for Health Economics), and Jun Yang (Hudson Institute) investigated whether screening for primary aldosteronism would be cost-effective.
Based on a hypothetical 40-year-old patient with hypertension living up to 80 years old, they found that primary aldosteronism screening was cost-effective in the Australian healthcare system and improved the patient’s overall health and quality of life.
Earlier screening and therefore milder diagnosis of primary aldosteronism, as it was done in Germany, means that treatment can be offered well before complications develop. Adopting as part of Australian healthcare practices the screening of primary aldosteronism in people with hypertension from age 40 is likely to greatly improve patient well-being and significantly reduce the financial burden on the Australian healthcare system.
Find the original academic paper here: Woode, M. E., Wong, K., Reid, C. M., Stowasser, M., Russell, G., Gwini, S. M., Young, M. J., Fuller, P. J, Yang, J., & Chen, G. (2023). Cost-effectiveness of screening for primary aldosteronism in hypertensive patients in Australia: a Markov modelling analysis. Journal of Hypertension, 41(10), 1615–1625. https://doi.org/10.1097/HJH.0000000000003513
Acknowledgement: This research was supported by funding from the Australian National Health and Medical Research Council (NHMRC) Ideas Grant (APP1184927) and Medical Research Future Fund (MRFF) Rapid Applied Research Translation Fund. The Hudson Institute is supported by the Victorian Government’s Operational Infrastructure Scheme.
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