Primary hyperaldosteronism – the most common form of secondary hypertension

Czech version

Authors: B. Štrauch; J. Widimský jr.
Authors‘ workplace: III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze, Centrum pro výzkum, diagnostiku a léčbu hypertenze
Published in: Kardiol Rev Int Med 2015, 17(2): 155-160
Category: Internal Medicine

Overview

Primary aldosteronism is the most common form not only of endocrine, but also secondary hypertension, associated with increased cardiovascular risk. It is caused by autonomous overproduction of aldosterone by the adrenal cortex. Clinically, it manifests with hypertension often resistant to treatment and hypokalaemia. The screening tool is the increased ratio of aldosterone/ renin due to increased concentrations of aldosterone and low levels of renin, and the diag-nosis is confirmed by the lack of suppression of aldosterone during confirmatory tests. Before indication for surgical treatment, adrenal venous sampling is used in the majority of patients to assess lateralization. In other cases is indicated treatment with aldosterone receptor blockers is indicated. Given the complexity of the diagnostic process, patients with suspected PH should be treated only in specialized centres.

Keywords:
primary aldosteronism – hypertension – aldosterone – renin

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