{"id":6407,"date":"2026-10-19T09:48:52","date_gmt":"2026-10-19T09:48:52","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-laeknavisindum-hrafnhildur-gunnarsdottir\/"},"modified":"2026-10-19T09:48:52","modified_gmt":"2026-10-19T09:48:52","slug":"doktorsvorn-i-laeknavisindum-hrafnhildur-gunnarsdottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-laeknavisindum-hrafnhildur-gunnarsdottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed l\u00e6knav\u00edsindum – Hrafnhildur Gunnarsd\u00f3ttir"},"content":{"rendered":"
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M\u00e1nudaginn 16. j\u00fan\u00ed 2025 ver Hrafnhildur Gunnarsd\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed l\u00e6knav\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: L\u00fd\u00f0grundu\u00f0 ranns\u00f3kn \u00e1 frumkomnu ald\u00f3ster\u00f3nheilkenni \u00e1 \u00cdslandi: Fr\u00e1 greiningu til m\u00f3tefnalitunar og erf\u00f0aranns\u00f3kna. A Nationwide Study on Primary Aldosteronism in Iceland: From Detection to Immunohistochemistry and Genetic Testing.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Martin Reincke, pr\u00f3fessor og yfirl\u00e6knir vi\u00f0 Ludwig-Maximilians h\u00e1sk\u00f3lasj\u00fakrah\u00fasi\u00f0 \u00ed M\u00fcnchen, og dr. Marianne Aardal Grytas, yfirl\u00e6knir vi\u00f0 Haukeland h\u00e1sk\u00f3lasj\u00fakrah\u00fasi\u00f0 \u00ed Bergen.\u00a0<\/p>\n

Lei\u00f0beinandi var dr. Helga \u00c1g\u00fasta Sigurj\u00f3nsd\u00f3ttir, kl\u00edn\u00edskur pr\u00f3fessor, og umsj\u00f3narkennari var dr. Ragnar Gr\u00edmur Bjarnason, pr\u00f3fessor. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd Bjarni A. Agnarsson, pr\u00f3fessor emeritus, og Gu\u00f0j\u00f3n Birgisson, skur\u00f0l\u00e6knir.<\/p>\n

S\u00e6d\u00eds S\u00e6varsd\u00f3ttir, pr\u00f3fessor og varadeildarforseti L\u00e6knadeildar, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0arsal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 9.00.<\/p>\n

\u00c1grip<\/strong><\/p>\n

Frumkomi\u00f0 ald\u00f3ster\u00f3nheilkenni (FA) er algengasta ors\u00f6k afleidds h\u00e1\u00fer\u00fdstings og orsakast af ofseytingu ald\u00f3ster\u00f3ns fr\u00e1 annarri e\u00f0a b\u00e1\u00f0um n\u00fdrnahettum. Sj\u00fakd\u00f3mnum fylgir aukin h\u00e6tta \u00e1 hjarta- og \u00e6\u00f0asj\u00fakd\u00f3mum samanbori\u00f0 vi\u00f0 h\u00e1\u00fer\u00fdsting af \u00f3\u00feekktum ors\u00f6kum. Vangreining og greiningart\u00f6f FA lei\u00f0a til verri \u00fatkomu.<\/p>\n

Markmi\u00f0 ranns\u00f3knarinnar var a\u00f0 meta n\u00fdgengi sj\u00fakd\u00f3msins, greiningara\u00f0fer\u00f0ir og me\u00f0fer\u00f0arsv\u00f6run auk \u00feess a\u00f0 meta notagildi m\u00f3tefnalitunar vi\u00f0 skipulag eftirfylgdar. Notast var vi\u00f0 gagnreyndan uppvinnsluferil sem f\u00f3l \u00ed s\u00e9r horm\u00f3nam\u00e6lingar, t\u00f6lvusnei\u00f0mynd, st\u00f6\u00f0upr\u00f3f og n\u00fdrnahettubl\u00e1\u00e6\u00f0a\u00fer\u00e6\u00f0ingu. Vefjagreining var endurmetin me\u00f0 s\u00e9rt\u00e6kri m\u00f3tefnalitun.<\/p>\n

Ranns\u00f3knar\u00fe\u00fd\u00f0i\u00f0 samanst\u00f3\u00f0 af \u00f6llum fullor\u00f0num sem greindust me\u00f0 FA \u00e1 \u00cdslandi \u00e1 \u00e1runum 2007-2016. Sj\u00faklingarnir voru 58 talsins, 47% h\u00f6f\u00f0u sj\u00fakd\u00f3m \u00ed annarri n\u00fdrnahettu og gengust undir n\u00fdrnahettubrottn\u00e1m, 53% h\u00f6f\u00f0u tv\u00edhli\u00f0a sj\u00fakd\u00f3m og fengu s\u00e9rt\u00e6ka lyfjame\u00f0fer\u00f0.\u00a0 Allir sj\u00faklingarnir h\u00f6f\u00f0u bl\u00f3\u00f0kal\u00eduml\u00e6kkun vi\u00f0 skimun e\u00f0a s\u00ed\u00f0ar \u00ed uppvinnsluferlinu sem bendir til vangreiningar og greiningartafar FA \u00e1 \u00cdslandi. Meiri l\u00e6kkun var\u00f0 \u00e1 bl\u00f3\u00f0\u00fer\u00fdstingi og lyfjanotkun hj\u00e1 a\u00f0ger\u00f0arsj\u00faklingum en \u00feeim sem fengu lyfjame\u00f0fer\u00f0, sem bendir til betri \u00fatkomu fyrrnefnda h\u00f3psins. S\u00e9rt\u00e6k m\u00f3tefnalitun j\u00f3k n\u00e1kv\u00e6mni greiningar og m\u00f6gulegt vir\u00f0ist a\u00f0 sn\u00ed\u00f0a eftirfylgd eftir ni\u00f0urst\u00f6\u00f0um litunarinnar.<\/p>\n

Ni\u00f0urst\u00f6\u00f0urnar undirstrika mikilv\u00e6gi \u00feess a\u00f0 vekja athygli \u00e1 FA, v\u00edkka \u00fat skimunar\u00e1bendingar og einfalda uppvinnsluferli\u00f0.<\/p>\n

Abstract<\/strong><\/p>\n

Primary aldosteronism (PA) is the most common cause of secondary hypertension and results from excess aldosterone production in one or both adrenal glands. PA carries a higher risk of cardiovascular complications than essential hypertension. Underdiagnosis and diagnostic delay are associated with poorer outcomes.<\/p>\n

The thesis aimed to assess the incidence of PA in Iceland, evaluate diagnostic procedures, and treatment outcomes, and explore the utility of immunohistochemistry (IHC) in guiding long-term follow-up. An evidence-based diagnostic protocol \u2013 including hormone testing, imaging, postural testing, and adrenal venous sampling \u2013 was applied, and histopathological reclassification using IHC was performed.<\/p>\n

All adults diagnosed with PA in Iceland from 2007 to 2016 were included (n=58). Of these, 47% had unilateral disease and underwent surgery, while 53% had bilateral disease and received medical treatment. All patients presented with or developed hypokalaemia during the diagnostic work-up, highlighting the extent of underdiagnosis and diagnostic delay. Surgical patients showed greater reductions in blood pressure and medication use, indicating better treatment outcomes. IHC improved diagnostic accuracy and showed potential for tailoring long-term follow-up.<\/p>\n

The findings underscore the need for increased awareness, broader screening, and simplified diagnostic pathways for PA.<\/p>\n

Um doktorsefni<\/strong><\/p>\n

Hrafnhildur Gunnarsd\u00f3ttir er f\u00e6dd \u00e1ri\u00f0 1991 \u00ed Reykjav\u00edk. H\u00fan \u00fatskrifa\u00f0ist \u00far n\u00e1tt\u00farufr\u00e6\u00f0ideild Menntask\u00f3lans \u00ed Reykjav\u00edk \u00e1ri\u00f0 2011, lauk kand\u00eddatspr\u00f3fi \u00ed l\u00e6knisfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2017 og kand\u00eddats\u00e1ri vi\u00f0 Landsp\u00edtala \u00e1ri s\u00ed\u00f0ar. Samhli\u00f0a doktorsn\u00e1minu hefur Hrafnhildur stunda\u00f0 s\u00e9rn\u00e1m \u00ed almennum lyfl\u00e6kningum \u00e1 Landsp\u00edtala og sinnt handlei\u00f0slu BS-nema. Foreldrar Hrafnhildar eru Hj\u00f6rd\u00eds J\u00f3hannesd\u00f3ttir og Gunnar Bergsveinsson. Eiginma\u00f0ur Hrafnhildar er Dan\u00edel Kristinn Hilmarsson og saman eiga \u00feau \u00ferj\u00e1r d\u00e6tur.<\/p>\n<\/div><\/div>","protected":false},"featured_media":5770,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2025-06-16T09:00:00+00:00","_phd_date_end":"2025-06-16T12:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"L\u00fd\u00f0grundu\u00f0 ranns\u00f3kn \u00e1 frumkomnu ald\u00f3ster\u00f3nheilkenni \u00e1 \u00cdslandi: Fr\u00e1 greiningu til m\u00f3tefnalitunar og erf\u00f0aranns\u00f3kna. 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