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Historical changes and between-facility differences in adrenal venous sampling for primary aldosteronism in Japan

Journal of Human Hypertension volume 34, pages 34–42 (2020)Cite this article

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Abstract

Primary aldosteronism (PA) is a common curable cause of hypertension. Adrenal venous sampling (AVS) is recommended for subtype diagnosis but is a difficult procedure. Recently, an increased prevalence of PA was reported, creating a greater demand for treatment of the condition in clinical facilities. The aim of the present study was to identify the historical changes over time and the differences between facilities in the success rate and subtype diagnosis of PA. The database of the PA registry developed by the Japan PA Study (JPAS) was used. A total of 2599 patients with PA who underwent AVS were evaluated. The overall success rate of AVS was 88%. The bilateral subtype was the dominant subtype, comprising 69% of cases. During the period 2004−2011 to 2011−2017, there were significant changes in the total number of AVS procedures (from 562 to 1732), ratio of ACTH administration with AVS (75 to 97%), success rate (79 to 90%), and proportion with bilateral subtype diagnosis (53 to 72%). There were also significant inter-facility differences in the number of AVS procedures (6 to 322), success rate (59 to 97%), and proportion with the bilateral subtype (44 to 86%). The principal enrolled department was Endocrinology (86%), and the ratio of unilateral PA was significantly higher in this department than in others (32% vs. 25%). In conclusion, the number of AVS procedures performed, the success rate, and the proportion with the bilateral subtype increased over time after normalizing the centre difference. Significant differences were observed between the centres.

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Acknowledgements

This study was conducted as a part of the JPAS and JRAS by a Research Grant from the Japan Agency for Medical Research and Development (AMED) under Grant Number JP17ek0109122,JP18ek0109352, and JP19ek0109352, andthe National Center for Global Health and Medicine, Japan (27-1402, 30-1008). We wish to thank Dr. Yukio Hirata at the Institute of Biomedical Research and Innovation Hospital and Dr. Kazuaki Shimamoto at Sapporo Medical University School of Medicine for interpreting the significance of the results of this study. We also wish to thank Dr. Masanobu Yamada at Gunma University, Tatsuya Kai at Saiseikai Tondabayashi Hospital, Ryuichi Sakamoto at Saiseikai Fukuoka Hospital for collecting the clinical data.

JPAS Study Group

Masanobu Yamada28, Hiromi Rakugi29, Takashi Kawamura30, Osamu Ogawa31, Toshinari Yamasaki31, Akiyo Tanabe32, Tomonobu Hasegawa33, Masanori Abe34, Ryuichi Sakamoto35, Takuro Shinbo36, Tatsuya Kai37, Tomikazu Fukuoka38, Masanori Murakami39, Shigeatsu Hashimoto40, Makito Tanabe41, Mitsuhiro Kometani42, Yuichirou Yoshikawa43, Youichi Oono44, Hisashi Fukuda45, Takashi Yoneda46, Touru Sugiyama47, Fumihiko Matsuda48, Takahisa Kawaguchi48

Author information

Authors and Affiliations

  1. Department of Cardiology, JR Hiroshima Hospital, Hiroshima, Japan

    Yuichi Fujii

  2. Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

    Yoshiyu Takeda

  3. Department of Endocrinology, Metabolism and Nephrology, School of Medicine Keio University, Tokyo, Japan

    Isao Kurihara & Hiroshi Itoh

  4. Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine Yokohama City Seibu Hospital, Yokohama, Japan

    Takuyuki Katabami

  5. Department of Endocrinology and Metabolism, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan

    Takamasa Ichijo

  6. Department of Diabetes and Endocrinology, Sapporo City General Hospital, Sapporo, Japan

    Norio Wada & Yui Shibayama

  7. Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Tokyo, Japan

    Takanobu Yoshimoto & Yoshihiro Ogawa

  8. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yoshihiro Ogawa

  9. Department of Metabolic Medicine, Faculty of Life Science, Kumamoto University, Kumamoto, Japan

    Junji Kawashima

  10. Department of Diabetes, Endocrinology and Nutrition, Kyoto University, Kyoto, Japan

    Masakatsu Sone & Nobuya Inagaki

  11. Division of Nephrology and Endocrinology, University of Tokyo School of Medicine, Tokyo, Japan

    Katsutoshi Takahashi

  12. Division of Metabolism, Showa General Hospital, Kodaira, Japan

    Katsutoshi Takahashi

  13. Department of Endocrinology and Diabetes, Okazaki City Hospital, Okazaki, Japan

    Minemori Watanabe

  14. Department of Cardiology, Sanda City Hospital, Sanda, Japan

    Yuichi Matsuda

  15. Division of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, Tokyo, Japan

    Hiroki Kobayashi

  16. Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan

    Hirotaka Shibata

  17. Department of Cardiology, Akashi Medical Center, Akashi, Japan

    Kohei Kamemura

  18. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Michio Otsuki

  19. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Koichi Yamamto

  20. Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Atsushi Ogo

  21. Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Toshihiko Yanase

  22. Department of Endocrinology and Metabolism, Tenri Hospital, Tenri, Japan

    Shintaro Okamura

  23. Department of Internal Medicine, Uwajima City Hospital, Uwajima, Japan

    Shozo Miyauchi

  24. Division of Nephrology and Endocrinology, University of Tokyo, Tokyo, Japan

    Megumi Fujita

  25. Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan

    Tomoko Suzuki

  26. Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan

    Hironobu Umakoshi, Tatsuki Ogasawara, Mika Tsuiki & Mitsuhide Naruse

  27. Endocrine Center, Ijinkai Takeda General Hospital, Kyoto, Japan

    Mitsuhide Naruse

  28. Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Japan

    Masanobu Yamada

  29. Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiromi Rakugi

  30. Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan

    Takashi Kawamura

  31. Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Osamu Ogawa & Toshinari Yamasaki

  32. Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Tokyo, Japan

    Akiyo Tanabe

  33. Department of Pediatrics, Keio University, Tokyo, Japan

    Tomonobu Hasegawa

  34. Division of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, Tokyo, Japan

    Masanori Abe

  35. Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Ryuichi Sakamoto

  36. Ohta General Hospital, Nishinouchi, Fukushima, Japan

    Takuro Shinbo

  37. Department of Cardiology, Saiseikai Tondabayashi Hospital, Tondabayashi, Japan

    Tatsuya Kai

  38. Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan

    Tomikazu Fukuoka

  39. Department of Molecular Endocrinology and Metabolism, Tokyo Medical and Dental University, Tokyo, Japan

    Masanori Murakami

  40. Division of Nephrology, Hypertension, Endocrinology, and Diabetology/ Metabolism, Aizu Medical Center, Fukushima Medical University Hospital, Fukushima, Japan

    Shigeatsu Hashimoto

  41. Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Makito Tanabe

  42. Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

    Mitsuhiro Kometani

  43. Division of Diabetes and Endocrinology, Misato Kenwa Hospital, Misato, Misato, Saitama, Japan

    Yuichirou Yoshikawa

  44. Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Youichi Oono

  45. Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Yokohama, Japan

    Hisashi Fukuda

  46. Department of Internal Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

    Takashi Yoneda

  47. Division of Endocrinology, Japanese Red Cross Musashino Hospital, Tokyo, Japan

    Touru Sugiyama

  48. Takahisa Kawaguchi, The Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Fumihiko Matsuda & Takahisa Kawaguchi

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  1. Yuichi Fujii
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JPAS Study Group

  • Masanobu Yamada
  • , Hiromi Rakugi
  • , Takashi Kawamura
  • , Osamu Ogawa
  • , Akiyo Tanabe
  • , Tomonobu Hasegawa
  • , Masanori Abe
  • , Ryuichi Sakamoto
  • , Takuro Shinbo
  • , Tatsuya Kai
  • , Tomikazu Fukuoka
  • , Masanori Murakami
  • , Shigeatsu Hashimoto
  • , Makito Tanabe
  • , Mitsuhiro Kometani
  • , Yuichirou Yoshikawa
  • , Youichi Oono
  • , Hisashi Fukuda
  • , Takashi Yoneda
  • , Touru Sugiyama
  • , Fumihiko Matsuda
  • , Toshinari Yamasaki
  •  & Takahisa Kawaguchi

Corresponding author

Correspondence to Yuichi Fujii.

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The authors declare that they have no conflict of interest.

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Members of the JPAS Study Group are listed at the end of the paper.

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Fujii, Y., Takeda, Y., Kurihara, I. et al. Historical changes and between-facility differences in adrenal venous sampling for primary aldosteronism in Japan. J Hum Hypertens 34, 34–42 (2020). https://doi.org/10.1038/s41371-019-0229-4

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