本會介紹
原發性醛固酮症，曾經一度被認為是一個罕見疾病，然而，隨著診斷技術之進步，已有研究指出其發生率在病人因高血壓被轉診至醫學中心之族群中可達11.2%，其中以腎上腺醛固酮分泌瘤為表現型,進而可透過手術方式而可被治癒的病人則將進5%。換言之，這群病人在經過正確之診療，進而治癒高血壓後，將無需再接受高血壓藥物之治療，同時病友因透過有效之血壓控制，可大幅降低未來發生心血管疾病之機會。
這樣的研究經驗與台灣本土之研究經驗相符。自民國90年以來，目前在台大醫院已有將近400位原發性醛固酮症之病友，且每年被診斷原發性醛固酮症之患者亦呈逐年增加之趨勢。有鑑於此，台大醫院腎臟科於民國95年成立台灣原發性醛固酮症研究群(Taiwan Primary Aldosteronism Study Group，TAIPAI Study Group)，透過跨科部之醫療整合，提供原發性醛固酮症病友最佳照護品質。經過多年之臨床經驗積累，於民國100年發表了台大醫院對於原發性醛固酮症之標準診療作業守則。不但診療品質可與世界其他頂尖之醫療團隊接軌，更具體展現出台大醫院實踐創意整合醫療之成果。目前也包含台大總院、台大各分院、慈濟醫院、恩主公醫院、衛生福利部桃園醫院等。
根據衛生署所發布之國人十大死因統計資料，心血管疾病—腦血管疾病、心臟疾病、糖尿病分佔國人十大死因之第二、三、四名，因心血管疾病死亡之人數與癌症相近，對國人健康影響甚鉅。同時，依據世界衛生組織之估計，全球每年有1700萬人死於心血管疾病，每五秒有一人因冠心病死亡，每六秒則有一人死於中風；世界衛生組織更預估心血管疾病於西元2020年將成為全球導致人類死亡與殘疾的首要原因。因此，心血管疾病儼然成為台灣以及全世界民眾最關心的健康殺手。為預防此三大類心血管疾病，高血壓的控制扮演極其關鍵之角色。其中，若能有效診斷唯一可被治癒之續發性高血壓–原發性醛固酮症，對國人之健康促進與健保之醫療支出無疑將有巨大助益。
放眼未來，台灣原發性醛固酮症研究群(TAIPAI study group)將持續精進診斷技術並嘗試創新之治療方式，以提供國人乃至於世界其他國家病友最有保障之診療。也期盼透過病友的熱心幫助，台灣原發性醛固酮症研究群能夠一直走在原發性醛固酮症研究的先端，進而成為台灣本土具有世界競爭力之特色醫療。
Title: "Pioneering Advances in Primary Aldosteronism: The Taiwan Society's Consensus Launch and Collaborative Milestones"
Primary aldosteronism (PA) was once considered a rare condition. However, with the widespread adoption of the aldosterone-to-renin ratio (ARR) for screening, the prevalence of PA among hypertensive patients has surged, ranging from 5% to 15%, and even up to 20% in cases of resistant hypertension. PA patients exhibit a higher prevalence of cardiovascular diseases and arrhythmias. Nearly half of PA cases are of the aldosterone-producing adenoma (APA) subtype, which can be cured through surgical intervention. With appropriate treatment, including surgery and medical approaches, blood pressure can be effectively controlled, reducing the risk of cardiovascular diseases.
Recognizing the paramount significance of PA, our scholarly endeavor took shape in 2006 with the establishment of the Taiwan Primary Aldosteronism Study Group, known as the TAIPAI Study Group, dedicated to multifaceted research on this intricate medical condition. The TAIPAI team diligently curated an extensive repository, amassing an impressive compilation of more than 700 adrenal specimens procured from PA patients, complemented by comprehensive data archives spanning 3,000 PA-afflicted individuals and 2,000 subjects afflicted with essential hypertension. The fruit of our rigorous labor is manifest in a noteworthy compilation of 150 papers, all indexed in esteemed SCI journals and published under the imprimatur of the TAIPAI banner, denoting a marked enhancement in both the quantity and caliber of our academic contributions.
In 2017, our tireless pursuit of excellence culminated in the establishment of the Taiwan Society of Aldosteronism (TSA) by the TAIPAI Study Group. This institutional edifice was erected with an unwavering commitment to spearheading avant-garde PA research, inextricably linked with the overarching mission of ensuring that PA patients receive the most superlative multidisciplinary care.
During the penultimate days of November 2021, TSA embarked on a momentous collaborative initiative, forging affiliations with venerable medical societies, including the Taiwan Society of Cardiology, the Taiwan Hypertension Society, the Endocrine Society of the Republic of China (Taiwan), the Taiwan Society of Nephrology, and the Taiwan Urological Association. This endeavor culminated in the formation of a distinguished task force, comprising illustrious practitioners specializing in primary aldosteronism (PA) across diverse medical domains, encompassing the fields of endocrinology, cardiology, nephrology, urology, radiology, nuclear medicine, and pathology. This formidable collective undertook the arduous task of convening a consensus conference, the fruits of which culminated in the conception of the 2022 Taiwan Consensus of Primary Aldosteronism. This seminal consensus underwent meticulous development, involving systematic reviews and meta-analyses and adhering to the exacting standards set forth by Cochrane Taiwan.
Notably, the 2022 Taiwan Consensus of Primary Aldosteronism stands as a beacon of innovation in its incorporation of insights from experts affiliated with five prominent medical societies, the integration of consensus derived from real-world clinical trials, and the pioneering inclusion of pathophysiological and genetic determinants in the prognostic and therapeutic schema. The consensus accord also marks a pioneering endeavor in patient engagement throughout the decision-making process, champions the promotion of autonomous cortisol secretion screening, and deploys a modified Delphi voting mechanism to affirm the consensus validity.
In April 2021, our research was recognized in the Frontier Endocrinology journal, with our SCI articles ranking second globally, underscoring our status as one of the world's leading centers for the diagnosis and treatment of primary aldosteronism.
One of our exceptional milestones was the receipt of the Outstanding Research. In 2022, we were honored with the Silver Medal of the Symbol of National Quality (SNQ), an accolade subject to rigorous scientific validation.
We eagerly welcome opportunities for collaboration with other PA study groups. Please feel free to contact us.