Primary aldosteronism and hypertension
Authors:
P. Vysočanová
Authors‘ workplace:
Interní kardiologická klinika LF MU a FN Brno
Published in:
Kardiol Rev Int Med 2018, 20(3): 178-180
Overview
Primary aldosteronism (PA), the most common cause of secondary hypertension, is reported in 4.3% of hypertensive patients. It is caused by the overproduction of aldosterone due to an adrenal disorder. Primary aldosteronism is associated with resistant hypertension, hypokalaemia and increased cardiovascular morbidity. Primary aldosteronism is diagnosed through a multistep procedure, beginning with measurement of the aldosterone-to-renin ratio, a basic screening test. Then confirmatory tests, the collection of blood samples and morphologic imaging need to be performed. A unilateral laparoscopic adrenalectomy for patients with documented unilateral primary aldosteronism is recommended. Medical treatment with a mineralocorticoid receptor (MR) antagonist (spironolactone) is recommended for patients with PA due to a bilateral adrenal disease or patients unwilling or unable to undergo surgery. Early diagnostics and treatment of the PA may resolve hypokalaemia, lower the blood pressure and reverse the cardiovascular morbidity caused by the aldosterone excess.
Key words:
primary aldosteronism – hypertension
Sources
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Cardiology Review
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