Blood samples from patients with documented primary aldosteronism are going to be (with the patients informed conscent) obtained to be stored in Uppsala Biobank for future scientific purposes.

Primary Aldosteronism

Hypertension

Hypertension Secondary

Uppsala University, the Department of Surgical Sciences

Screening for Primary Aldosteronism in a Population of Patients With Hypertension

ARR - Aldosterone-Renin Ratio; i.v. - intravenous; NaCl - sodium chloride;

Percentage - relevant to the number of discovered cases of PA.

Those patients who get the diagnosis of PA after the initial screening and further investigations by the study protocol will be offered specific medical or surgical treatment - depending on the subtype of PA.
In both medically and surgically treated patients the assessment is going to include blood pressure level, usage of MRA and their doses, usage of other antihypertensive medications, their number and doses, frequency of significant side effects of MRA such as gynecomastia, gynecodynia, erectile dysfunction, decreased libido, menstrual disturbances.

Supplementation measured as "still needed" or "not needed".

As plasma aldosterone is measured in pmol/l and plasma Direct Renin Concentration (DRC) in mU/l, ARR is accordingly measured as pmol/mU. The measure of ARR will be evaluated as at the initial ARR screening.

Changes from baseline in pain scores on the Visual Analog Scale at postoperative day one and two, and at 1 year postoperatively.

Number of days. Applies to working study participants.

Proportion of operated patients who have had any surgical complications.

Proportion of cases where converting to open procedure was needed.

Proportion of patients who have underwent AVS and have had any complications.

Per Hellman

Professor, Head of the Department of Surgical Sciences, Uppsala University

Uppsala University

Uppsala-Örebro Regional Research Council

Patients in the intervention group will measure their blood pressure with home blood pressure monitor which is linked to a secured website. Patients will measure as recommended in the European guidelines of hypertension. This includes 2 measurements in the morning and two times in the evening on 7 consecutive days every month. The measurements of the first day will be discarded. These measurements will be forwarded to the web-based system, which will be managed by the nurse practitioner and the research doctor. At least every month patients are contacted about the state of their condition. If needed, antihypertensive medication is added of adjusted by the nurse practitioner or research doctor under the supervision of one consultant physician. Tailored lifestyle advices are given every month.

Patients measure their own bloodpressure and the results are shown at a secured website after USB connection of the monitor to the computer. Patients receive medication adjustments and lifestyle advices via this secured website.

hyperaldosteronism/nicotina

Screening for Primary Aldosteronism in a Population of Patients With Hypertension

Web Based Interactive Treatment and Self-monitoring in Hypertension

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