Primary Aldosteronism
Key Points
Key Points
Such inappropriate production of aldosterone causes hypertension, cardiovascular damage, sodium retention, suppression of plasma renin, and increased potassium excretion that (if prolonged and severe) may lead to hypokalemia.
- Only 9–37% of patients with PA have hypokalemia.
PA is commonly caused by an adrenal adenoma, unilateral or bilateral adrenal hyperplasia (BAH), or in rare cases adrenal carcinoma or inherited conditions of familial hyperaldosteronism.
Cross-sectional and prospective studies report PA in >5% and possibly >10% of hypertensive patients, both in general and in specialty settings.
Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential hypertension and the same degree of BP elevation.
Specific treatments, either by mineralocorticoid receptor (MR) antagonists or unilateral adrenalectomy, are available that ameliorate the impact of this condition on important patient outcomes.
Diagnosis
...agnosis
...mends using the plasma aldosterone/renin rat...
...stead of proceeding directly to subt...
...in the setting of spontaneous hypokalemia, p...
...mends that all patients with PA undergo a...
...ends that when surgical treatment is feasib...
...patients (< age 35 years) with spontan...
...ents with an onset of confirmed PA earlier th...
...y young patients with PA, ES suggests t...
...re 1. Algorithm for the Detection, Co...
...With High Prevalence of PAHaving trouble vie...
...actors That May Lead to False-Positive or False-N...
...e 3. Measurement of ARR: A Suggest...
...e 4. ARR Cutoff Values, Depending on Assay an...
.... Medications With Minimal Effects on...
...Confirmatory TestsHaving trouble viewing tab...
Treatment
...eatment...
...unilateral laparoscopic adrenalectomy for...
...a patient is unable or unwilling to...
...sitive patient is unwilling or unabl...
...atients with GRA, ES recommends administ...
...Summary of Systematic Reviews Address...
...tomy vs. MR antagonists...
...trol (M) ()699
...ce in LV mass reduction (L) ()699...
...PAWeighted mean prevalence of elevat...
...uracy of CT and MRI in diagnosing laterality o...
... ARR as a screening test for PADiagnostic accura...