Study maps barriers to diagnosing primary aldosteronism

New research from Australia identifies clinician, diagnostic, access and health-system barriers that make primary aldosteronism harder to screen for and diagnose. The findings point to changes beyond awareness campaigns, including better specialty access and stronger clinician networks.

Why it matters: - Primary aldosteronism is a common but often missed cause of hypertension. - Delayed or missed diagnosis can leave patients without targeted treatment for a condition that may drive high blood pressure. - The findings suggest that improving care will require changes in how clinicians, specialists and health systems work together.

What happened: - The Primary Aldosteronism Foundation recognized publication of a new study, "Clinician Decision Making in Managing Primary Aldosteronism: A Qualitative Study." - Sandra Hakim and colleagues studied the experiences and perspectives of 38 clinicians in Australia. - The clinicians included cardiologists, endocrinologists, general practitioners and nephrologists. - The study examined why primary aldosteronism screening and diagnosis remain difficult in everyday practice.

The details: - The researchers identified four connected barriers shaping decisions about screening, diagnosis and treatment. - Those barriers were clinician knowledge, experience and perceptions. - The second barrier was the complexity and burden of PA screening and diagnosis. - The third barrier was access to specialized services and information. - The fourth barrier was health-system and organizational factors. - Clinicians reported uncertainty about which patients should be screened. - Clinicians also described the diagnostic process as complex or burdensome. - Limited access to specialized services created another obstacle. - Broader health-system barriers also slowed diagnosis and treatment. - The study identified factors that can help improve care, including access to specialized diagnostic services. - Stronger professional networks across disciplines also helped support better care. - Rene Moreno, co-director and co-founder of PAF, said the research helps explain the real-world barriers between patients and an accurate diagnosis. - Moreno said the findings can help guide efforts to improve screening, diagnosis and access to appropriate treatment. - PAF co-founder Dr. Marianne Leenaerts helped fund the research after recognizing the need to better understand barriers to timely diagnosis and treatment. - The publication is dedicated to Leenaerts' memory and recognizes her advocacy for people with primary aldosteronism.

Between the lines: - The study argues that awareness alone is not enough to fix underdiagnosis. - The most important barriers appear to be practical and structural, not just educational. - That makes primary aldosteronism a systems problem as much as a clinical one. - The research also reflects a broader push to move uncommon or underrecognized conditions into routine diagnostic pathways.

What's next: - PAF is using the findings to support efforts aimed at better screening, diagnosis and treatment access. - The foundation also continues its education, advocacy and research support work around primary aldosteronism. - The open-access publication is available through the foundation's announcement: Read the open-access publication.

The bottom line: - Better primary aldosteronism care will likely depend on more than awareness campaigns. - The study points to specialty access, clinician support and system-level fixes as key next steps.