Primary Aldosteronism and Drug Resistant Hypertension: A “Chicken-Egg” Story

Author:

Lenzini L1,Pintus G1,Rossitto G1,Seccia T M1,Rossi G P1

Affiliation:

1. Internal & Emergency Medicine Unit, Department of Medicine – DIMED, University of Padua, Padua, Italy

Abstract

AbstractDrug-resistant arterial hypertension (RH) is a major risk factor for cardiovascular disease, often due to overlooked underlying causes. Identification of such causes poses significant clinical challenges. In this setting, primary aldosteronism (PA) is a frequent cause of RH and its prevalence in RH patients is likely higher than 20%.The pathophysiological link between PA and the development and maintenance of RH involves target organ damage and the cellular and extracellular effects of aldosterone excess that promote pro-inflammatory and pro-fibrotic changes in the kidney and vasculature.The feasibility of adrenal vein sampling in PA patients with RH, and the clinical benefit achieved by adrenalectomy, further emphasize the need to implement systematic screening for this common form of secondary hypertension in the management of a high-risk population as RH patients. We herein review the current knowledge of the factors that contribute to the RH phenotype with a focus on PA and discuss the issues regarding the screening for PA in this setting and the therapeutic approaches (surgical and medical) aimed at resolving RH caused by PA.

Publisher

Georg Thieme Verlag KG

Subject

Endocrinology,General Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

Cited by 2 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. Progress in Primary Aldosteronism 7: No better time to meet!;Experimental and Clinical Endocrinology & Diabetes;2023-08

2. Primary Aldosteronism: A Series of 11 Cases;JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH;2023

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