Primary Aldosteronism (PA) affects about 10 % of all individuals with hypertension. This disease is caused by overproduction of aldosterone from the adrenal gland, which increases blood pressure, remodels the cardiovascular system, and leads to the risk of heart disease, stroke, kidney damage. Compared with essential hypertension, patients with PA are much more likely to develop cardiovascular complications, hence early identification of these patients is required. To diagnose PA in patients with hypertension, aldosterone together with renin are measured in serum. If the ratio between aldosterone and renin is high, PA may be suspected. To verify the diagnosis a confirmatory test is used. Because the disease may affect one or both adrenals, the next step is to use adrenal vein sampling, a complicated and invasive procedure. However, if unilateral disease is confirmed, the patient may be treated with surgery. This may cure about 50% of patients, and improve disease control and prognosis in almost all other cases. Bilateral disease can be treated conservatively by mineralocorticoid receptor antagonists – that, when adequately titrated, give protection against many of the complications of PA. Our aim has been to investigate liquid biomarkers for improved PA diagnosis. We used a cohort of PA patients which included 29 unilateral cases, 29 bilateral cases and 30 hypertensive control cases. Using the OLINK cardiometabolic panel we were able to find a protein profile in serum that distinguished PA from primary hypertensive cases. Hence, we would like to validate this finding in a separate cohort. The UK Biobank includes 189 cases of PA and about 10000 with hypertension. This impressive cohort was subjected to proteomic profiling of 3000 proteins. We believe that this cohort could be used to validate and perhaps expand on our prior findings. Our ultimate goal is thus to improve the care for patients with PA.
