Primary Hyperaldosteronism: When to Suspect It and How to Confirm Its Diagnosis

Author:

Ruiz-Sánchez Jorge GabrielORCID,Pazos Guerra MarioORCID,Meneses DiegoORCID,Runkle Isabelle

Abstract

The definition of primary hyperaldosteronism (PA) has shifted, as progress has been made in understanding the disease. PA can be produced by unilateral or bilateral cortical adrenal hyperproduction of aldosterone, due to hyperplasia, aldosterone-secreting cell clusters, aldosterone-producing macro or micro adenoma/s, and combinations of the above, or by an aldosterone-producing carcinoma. PA is a highly prevalent disease, affecting close to 10% of the hypertensive population. However, PA is clearly underdiagnosed. The purpose of this review is to address current knowledge of PA’s clinical manifestations, as well as current methods of diagnosis. PA is associated with a higher cardiovascular morbidity and mortality than essential hypertension with similar blood pressure control. Young hypertensive patients, those with a first-degree relative with PA or ictus, and/or those with apnea/hypopnea syndrome, moderate/severe/resistant hypertension, adrenal incidentaloma, and/or hypokalemia should be screened for PA. PA can induce atrial fibrillation (AF), and those patients should also be screened for PA. We propose the use of the Captopril challenge test (CCT), oral salt loading, or intravenous salt loading for PA diagnosis, given their availability in the majority of hospital centers. CCT could be first-line, since it is safe and easy to perform.

Publisher

MDPI AG

Subject

General Medicine

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Primary hyperaldosteronism in Acute Central Serous Chorioretinopathy: a real need for screening?;Graefe's Archive for Clinical and Experimental Ophthalmology;2023-07-25

2. Impacto de una consulta de hipertensión endocrina en el diagnóstico del hiperaldosteronismo primario;Endocrinología, Diabetes y Nutrición;2023-05

3. Impact of an endocrine hypertension unit on the diagnosis of primary aldosteronism;Endocrinología, Diabetes y Nutrición (English ed.);2023-05

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