MON-292 Are We There Yet? Geospatial Resource Allocation for the Treatment of Primary Hyperaldosteronism

Abstract Disclosure: S. Moronta: None. J. Hall: None. K. Kumar: None. C. Cunningham: None. F. Nwariaku: None. J.L. McMullin: None. Background: Primary hyperaldosteronism (PA) is a grossly underdiagnosed cause of hypertension that has the potential to be cured surgically. Adrenal surgeons are distributed widely across the United States, as are centers that provide the adrenal vein sampling (AVS) required for PA workup. Our objective was to perform a geospatial analysis to identify how our resources for treating PA are allocated nationally. Methods: The American Association of Endocrine Surgeons (AAES) web-based “find a surgeon” directory was utilized to identify society-affiliated surgeons who treat adrenal pathology. High-volume AVS centers (>20 procedures annually) were identified using survey data administered to interventional radiologists. Medical centers with AAES adrenal surgeons and high-volume AVS centers were mapped utilizing Mapline software, and a geospatial analysis was performed. Results: We geocoded 228 addresses of adrenal centers across the U.S. and related their location to 45 high-volume AVS centers (fig 1). Nine states did not have any AAES adrenal surgeons, while 25 states did not have high-volume AVS centers. By census regions, there were 54 adrenal centers in the Northeast and 9 AVS centers (averaging 1,066,836 persons/center and 6,401,016 persons/center, respectively), 2 and 0 in the Pacific (1,094,331 and no centers persons/center), 85 and 15 in the South (1,485,484 and 8,417,740 persons/center), 46 and 8 in the Midwest (1,499,684 and 8,623,182 persons/center), and 41 and 12 in the West (1,863,412 and 6,366,659 persons/center). California and New York had the most surgical centers each with 24, followed by Texas with 18 centers. Over 2,320,300 square miles of the US was considered a ‘dead zone’ where there were no adrenal services within 100-miles. The longest drive time to reach an adrenal center was 25.5 hours in Alaska and 12.5 hours bisected between Washington and North Dakota in the contiguous U.S. The median driving distance and time was 262.15 miles and 4.67 hours, respectively. Conclusion: There remain significant areas of the U.S. with limited access to high-volume adrenal surgeons and AVS capabilities and a disparate distribution of surgeons and AVS centers across the country. Further work is needed to address and improve access to care nationally to workup and treat surgically correctable primary hyperaldosteronism. Presentation: Monday, July 14, 2025