Prevalence of Primary Aldosteronism in Hypertensive Patients Presenting With Atrial Flutter or Fibrillation

Primary objective of the PAPPHY Study is to establish the prevalence of primary aldosteronism (PA) in consecutive hypertensive patients referred for 'lone' paroxysmal, persistent or permanent atrial flutter or fibrillation (AFF). Design: cohort multicenter prospective study. State-of-the-art criteria and guidelines were followed for case detection and management of both PA and of AF in all enrolled patients (Funder J. J Clin Endocrinol Metab 2008 and 2016; Kirchhof P. Eur Heart J 2011 and 2016).

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Unequivocal evidence (by ECG, Holter ECG or medical charts) of AFF (paroxysmal, persistent or permanent) in patients with blood pressure \> 140/90 mmHg on at least 3 office measurements, or current use of anti-hypertensive drugs;
* Written informed consent.

Exclusion Criteria:

* Patient refusal to participate to the study;
* Moderate-severe valvular or congenital or myocardial heart disease;
* Current abnormal thyroid function;
* Chronic renal failure (sCreatinine \> 200 μM or eGFR \< 40 ml/min, calculated with MDRD formula);
* Hemochromatosis;
* Alcohol abuse;
* Acute coronary syndrome, or history of CABG, PTCA with/without stenting, acute myocardial infarction;
* Hepatitis C virus and/or B and/or HIV infection;
* Pheochromocytoma and other known secondary forms of arterial hypertension;
* Hemodynamic instability precluding withdrawal of drugs (e.g. β-blockers, ARBs, ACE-I, diuretics), interfering with PRA (or DRA) and aldosterone measurements.

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