UPCOMING THINK TANKS

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COMPLETED THINK TANKS

Primary Aldosteronism, an Emerging Disease — Improving Management and Long-Term Outcomes

Meeting organizer: Oskar Ragnarsson, University of Gothenburg
10-11 April 2025
Conference center Wallenberg, Gothenburg, Sweden

Primary aldosteronism (PA) is the most common cause of secondary hypertension, affecting at least 5% of all patients with high blood pressure and 20% of patients with therapy-resistant hypertension. Without disease-specific treatment, PA is associated with a significant risk of cardiovascular diseases, renal failure, and death.

On April 10-11, during a lunch-to-lunch meeting, 40 experts in PA from all parts of Sweden— including endocrinologists, endocrine surgeons, interventionists and research nurses—met in Gothenburg to discuss ongoing national studies, as well as new and groundbreaking research on managing patients with PA.

The focus of the meeting was on an ongoing randomized controlled trial where patients with unilateral PA are randomized to either medical or surgical treatment: Unilateral primary aldosteronism, mineralocorticoid antagonists versus surgical treatment (UPA-MEST). The main hypothesis is that medical treatment with adequate doses is as effective as adrenalectomy. Currently, 50 of 80 patients have been included and the first results are expected in spring 2027.

Other topics discussed during the meeting were adrenal venous sampling where Augustinas Sakinis, radiological interventionist at the Sahlgrenska University Hospital, discussed pearls and pitfalls of this challenging investigation. Per Hellman, professor in endocrine surgery at the Uppsala University Hospital, gave an overview of new and upcoming PET techniques for PA. Endocrinologist Cristina Volpe and associate professor in pathology Christofer Juhlin, both at the Karolinska University Hospital, talked about the new histopathological classification of PA (HISTALDO) and its importance for follow-up of surgically treated patients. Finally, two new international consensus documents were presented: the new outcome classification for medically treated patients (PAMO) and a new PA severity classification.

Significant progress has recently been achieved in the management of patients with PA. However, challenges remain, and several aspects of diagnosis, treatment, and follow-up still require further investigation. The ongoing national collaboration in Sweden—characterized by access to large patient cohorts, advanced diagnostic methods, a well-structured healthcare system, and high-quality registry data—plays a crucial role in driving further progress in this field.

The Swedish Tobacco Cohort

Guest Editor: Aron Naimi-Akbar, Malmö University
30 September - 1 October 2024
Hotell Gässlingen, Skanör, Sweden

The Swedish Tobacco Cohort (SWETOC) is a national cohort study on prospective data registered in databases and registers. The aim is to study the health effects of tobacco—and in particular, snus—exposure. Oral moist snuff (snus) is a smokeless tobacco product used in Sweden and has been proposed as a less harmful alternative to smoking, yet evidence is lacking regarding the risks. The exposure data is based on information retrieved from the Swedish Public Dental Service (Folktandvården), and that data is linked to several national registers. The Swedish Public Dental Service is present in every Swedish region, and the fact that it follows healthy subjects regularly makes the data extremely useful for our purpose.

The data collection process is finished, and we have included roughly six million people in the cohort. Approximately 700,000 people have at least one registration as a smoker, and the same number have at least one registration as a snus user. The linked register data is from Statistics Sweden, the National Board of Health and Welfare, the Swedish Social Insurance Agency and the Public Health Agency of Sweden. The cohort presents a wide range of research possibilities. We are currently at the early stages of data preparation and planning statistical analyses.

The Think Tank included researchers with a variety of research expertise, such as cancer epidemiology, cardiovascular epidemiology, health promotion, oral epidemiology and biostatistics. The original team that had been working on data collection and planning was expanded with new collaborators. The Think Tank included sessions aimed at presenting the data collection process and the exposure data, prioritizing potential research questions, and outlining the plan for the initial manuscripts.

METS-Microbiome: Gut microbiota, short chain fatty acids and obesity and type 2 diabetes risk across the Epidemiologic Transition Location: the Department of Physiology, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana 21-24 June 2022.

The Modeling the Epidemiologic Transition Study (METS) is an ongoing longitudinal study of obesity risk in populations of African origin in the US, Ghana, South Africa, Jamaica and Seychelles. 2000 METS participants have been prospectively followed since 2010, originally through the original METS grant but more recently through the METS-Microbiome and METS-Sleep studies. Now in their 10th year of follow-up, the METS studies continue to elucidate important findings regarding the impact of rapid demographic and nutrition transitions on populations of African origin.

The JIM Think Tank brought together the original METS investigators and new collaborators to celebrate the METS scientific achievements and plan future METS studies. The JIM Think Tank provided a critical training and mentoring opportunity for students from Ghana, South Africa and the US as they learned from the notable and distinguished METS investigators.

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