Association Between Papillary Thyroid Cancer and Primary Aldosteronism in Individuals With Hypertension - Scorecard - MDSpire

Association Between Papillary Thyroid Cancer and Primary Aldosteronism in Individuals With Hypertension

  • By

  • Ana Alice W Maciel

  • Debora L S Danilovic

  • Ibere C Soares

  • Thais C Freitas

  • Jessica Okubo

  • Gustavo F C Fagundes

  • Felipe Freitas-Castro

  • Lucas S Santana

  • Augusto G Guimaraes

  • Vinicius F Calsavara

  • Felipe L Ledesma

  • Luciana A Castroneves

  • Fernando M A Coelho

  • Victor Srougi

  • Fabio Y Tanno

  • Jose L Chambo

  • Francisco C Carnevale

  • João V Silveira

  • Fernanda M Consolim-Colombo

  • Luiz A Bortolotto

  • Luciana P Brito

  • Maria Candida B V Fragoso

  • Luciano F Drager

  • Celso E Gomez-Sanchez

  • Ana Claudia Latronico

  • Berenice B Mendonca

  • Ana O Hoff

  • Madson Q Almeida

  • September 18, 2024

  • 0 min

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Clinical Scorecard: Link Between Primary Aldosteronism and Papillary Thyroid Cancer in Patients With Hypertension

At a Glance

CategoryDetail
ConditionPrimary aldosteronism (PA) and papillary thyroid cancer (PTC) in hypertensive patients
Key MechanismsAldosterone excess induces oxidative stress and cell proliferation; PA causes autonomous aldosterone production leading to hypertension
Target PopulationAdults with arterial hypertension, including those with papillary thyroid cancer
Care SettingHypertension and oncology outpatient clinics, specialized endocrine and cardiovascular centers

Key Highlights

  • PTC is independently associated with a higher prevalence of PA in hypertensive individuals.
  • After matching for hypertension stage, PA prevalence is significantly higher in PTC patients compared to hypertensive controls.
  • Screening for PA is recommended in patients with PTC and hypertension regardless of hypertension severity.

Guideline-Based Recommendations

Diagnosis

  • Screen for PA in all hypertensive patients with papillary thyroid cancer regardless of hypertension severity.
  • Use aldosterone/direct renin concentration (A/DRC) ratio >2 ng/dL/µIU/mL as a positive screening threshold for PA.

Management

  • Early diagnosis of PA is essential for targeted treatment and hypertension control to prevent organ damage and cardiovascular morbidity.

Monitoring & Follow-up

  • Monitor blood pressure and biochemical markers (aldosterone and renin levels) in hypertensive patients with PTC.
  • Follow-up for recurrence of PTC in patients diagnosed with PA.

Risks

  • Undiagnosed PA in hypertensive patients with PTC may lead to uncontrolled hypertension and increased cardiovascular risk.

Patient & Prescribing Data

Patients with papillary thyroid cancer and arterial hypertension

Identification of PA allows for specific treatment strategies to control hypertension and reduce cardiovascular risk.

Clinical Best Practices

  • Employ propensity score matching to accurately assess PA prevalence in PTC patients with hypertension.
  • Consider PA screening in hypertensive patients with PTC even if hypertension is not severe or resistant.
  • Exclude secondary causes of hypertension and confounding medications before PA screening.

References

Original Source(s)

Association Between Papillary Thyroid Cancer and Primary Aldosteronism in Individuals With Hypertension

  • by Ana Alice W Maciel, Debora L S Danilovic, Ibere C Soares, Thais C Freitas, Jessica Okubo, Gustavo F C Fagundes, Felipe Freitas-Castro, Lucas S Santana, Augusto G Guimaraes, Vinicius F Calsavara, Felipe L Ledesma, Luciana A Castroneves, Fernando M A Coelho, Victor Srougi, Fabio Y Tanno, Jose L Chambo, Francisco C Carnevale, João V Silveira, Fernanda M Consolim-Colombo, Luiz A Bortolotto, Luciana P Brito, Maria Candida B V Fragoso, Luciano F Drager, Celso E Gomez-Sanchez, Ana Claudia Latronico, Berenice B Mendonca, Ana O Hoff, Madson Q Almeida

  • September 18, 2024

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