Article ; Online: Rates of Pheochromocytoma/Paraganglioma Screening in At-Risk Populations.
The Journal of clinical endocrinology and metabolism
2022 Volume 108, Issue 6, Page(s) e343–e349
Abstract: Context: Pheochromocytomas and paragangliomas (PPGL) are rare causes of secondary hypertension, but when unrecognized, they can lead to serious complications. Data regarding PPGL screening are lacking.: Objective: This study aimed to assess the rates ...
| Abstract | Context: Pheochromocytomas and paragangliomas (PPGL) are rare causes of secondary hypertension, but when unrecognized, they can lead to serious complications. Data regarding PPGL screening are lacking. Objective: This study aimed to assess the rates and patterns of PPGL screening among eligible patients. Methods: We conducted a retrospective review of adults with hypertension seen in outpatient clinics of a large academic center between January 1, 2017, and June 30, 2020. We included patients with treatment-resistant hypertension, hypertension at age < 35 years, and/or adrenal mass(es). Results: Of 203 535 patients with hypertension identified, 71 088 (35%) met ≥ 1 inclusion criteria, and 2013 (2.83%) were screened for PPGL. Patients screened were younger (56.2 ± 17.4 vs 64.0 ± 17.1 years), more often women (54.1% vs 44.2%), and never-smokers (54.6% vs 47.5%, P < 0.001 for all). The rate of screening was highest in patients with hypertension and adrenal mass(es) (51.7%, vs 3.9% in patients with early-onset hypertension, and 2.4% in those with treatment-resistant hypertension). Multivariable logistic regression showed higher odds ratio (OR) of PPGL screening in women (OR [95% CI]: 1.48 [1.34-1.63]); Black vs White patients (1.35 [1.19-1.53]); patients with adrenal mass(es) (55.1 [44.53-68.15]), stroke (1.34 [1.16-1.54]), dyslipidemia (1.41 [1.26-1.58]), chronic kidney disease (1.40 [1.26-1.56]), and obstructive sleep apnea (1.96 [1.76-2.19]). Conclusion: PPGL screening is pursued in roughly half of patients with adrenal nodules and hypertension, but rarely in patients with treatment-resistant or early-onset hypertension. Similar to screening for other forms of secondary hypertension, PPGL screening occurs more often after serious complications develop. |
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| MeSH term(s) | Adult ; Humans ; Female ; Pheochromocytoma/complications ; Pheochromocytoma/diagnosis ; Pheochromocytoma/epidemiology ; Paraganglioma/diagnosis ; Paraganglioma/epidemiology ; Paraganglioma/complications ; Risk Factors ; Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/epidemiology ; Hypertension/complications ; Hypertension/diagnosis ; Hypertension/epidemiology |
| Language | English |
| Publishing date | 2022-12-07 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural |
| ZDB-ID | 3029-6 |
| ISSN | 1945-7197 ; 0021-972X |
| ISSN (online) | 1945-7197 |
| ISSN | 0021-972X |
| DOI | 10.1210/clinem/dgac701 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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