HIGH PREVALENCE OF PRIMARY ALDOSTERONISM IN UNSELECTED HYPERTENSIVE PATIENTS ADMITTED FOR ATRIAL ARRYTHMIA ABLATION

Objective: Primary objective was to precise the prevalence of primary aldosteronism (PA) in a population of hypertensive patient admitted for atrial arrythmia ablation. Design and method: We prospectively and consecutively recruited hypertensive patients admitted for atrial arrythmia ablation in Bordeaux ESH excellence center et Pau Blood pressure clinic, presenting no contre-indication to interfering medication suspension. We performed a screening for primary aldosteronism in all these patients according to the current guidelines to report the prevalence, and we looked for predictors of PA diagnosis in our population. Results: Between May 2020 and June 2023, we included 300 hypertensive patients. After exclusion of 64 patients which ultimately did not benefit from PA screening, PA prevalence in our population was 43/236 (18%). Female sex, diastolic blood pressure above 78 mmHg, potassium level below 4 mmol/l, creatinine level above 91 μmol/l, number of ablation procedure above one and presence of left ventricular hypertrophy were independant predictors of PA diagnosis. In patients with 2 or less of the previously cited predictive factors, PA prevalence was of 7% (in 121 patients). In patients with 3 or more predictive factors, prevalence was of 31% (in 115 patients) Conclusions: In a population of unselected hypertensive patients admitted for atrial arrythmia ablation, prevalence of primary aldosteronism was as high as 18%. This reinforces the recommendation of performing a systematic screening in this population. Six predictives factors of primary aldosteronism diagnosis have been identified, allowing to define both low and very high prevalence groups in our population.