Dr Renata Libianto

High blood pressure caused by hormonal imbalance - how common is it, and how do we detect it?

Dr Renata Libianto, Monash University

2018 Health Professional Scholarship

Years funded: 2019-2022

Hypertension affects millions of Australians and is a leading risk factor for heart attack and stroke. Most people with hypertension have "essential hypertension" (i.e. they have no reversible cause), but a proportion have a treatable secondary cause such as primary aldosteronism (PA). PA is condition of excess aldosterone production by the adrenal glands. Aldosterone is the hormone responsible for controlling blood pressure, and if produced in excess will have adverse effects on the cardiovascular system, above and beyond the effect which would be expected from just hypertension. If diagnosed, PA can be treated effectively with either surgery or with medication which blocks aldosterone action.

Despite increasing recognition of PA as a major public health issue, the rate of screening for PA in the primary care setting is low. One of the barriers to making a timely diagnosis of PA is the paucity of data on its exact prevalence, and therefore the cost-effectiveness of screening. Furthermore, we have few clinical markers to help distinguish PA from essential hypertension.

This project, therefore, aims to establish the prevalence of PA in primary care; and to identify early clinical features and cellular markers that may help distinguish PA from essential hypertension. The results from this study will further our understanding of the epidemiology and pathophysiology of PA, and may lead to a greater emphasis on the importance of PA in the management of hypertension.

This project is co-funded with NHMRC - National Health and Medical Research Council.