Michio Otsuki    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor and Division head
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Historical changes and between-facility differences in adrenal venous sampling for primary aldosteronism in Japan
Journal	Formal name：Journal of human hypertension Abbreviation：J Hum Hypertens ISSN code：09509240/14765527
Domestic / Foregin	Foregin
Volume, Issue, Page	34(1),pp.34-42
Author and coauthor	Fujii, Y. Takeda, Y. Kurihara, I. Itoh, H. Katabami, T. Ichijo, T. Wada, N. Shibayama, Y. Yoshimoto, T. Ogawa, Y. Kawashima, J. Sone, M. Inagaki, N. Takahashi, K. Watanabe, M. Matsuda, Y. Kobayashi, H. Shibata, H. Kamemura, K. Otsuki, M. Yamamto, K. Ogo, A. Yanase, T. Okamura, S. Miyauchi, S. Fujita, M. Suzuki, T. Umakoshi, H. Ogasawara, T. Tsuiki, M. Naruse, M. Jpas Study Group
Publication date	2019
Summary	Primary aldosteronism (PA) is a common curable cause of hypertension. Adrenal venous sampling (AVS) is recommended for subtype diagnosis but is a difficultprocedure. 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.
DOI	10.1038/s41371-019-0229-4
Document No.	31462725