Primary aldosteronism is the most frequent form of secondary hypertension. It is characterized by an autonomous, inappropriately high and unsuppressible production of aldosterone. The prevalence of aldosteronism in the general population is from 5-12% with bilateral adrenal hyperplasia and aldosterone-producing adenoma being the two main causes. Primary aldosteronism may either be sporadic or familial, the latter variant occurring in at least three forms: type I (or glucocorticoid-remediable aldosteronism), type II and type III. The diagnosis is based on the aldosterone/renin ratio as a screening test, subsequent confirmatory tests, and on CT/MR imaging studies. Adrenal vein sampling is the gold standard test for diagnosing the major subtypes and for identifying the surgically correctable forms. Genetic testing is used to exclude the familial forms.
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Shifting paradigms in primary aldosteronism: reconsideration of screening strategy via integrating pathophysiological insights.
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Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan.
Several decades have passed since the description of the first patient with primary aldosteronism (PA). PA was initially classified in two main forms: aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). However, the pathogenesis of PA has now been shown to be far more complex.
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Department of Radiology, University of Yamanashi, Chuo, Yamanashi.
Objective: This study aims to identify factors associated with the detectability of the right adrenal vein (RAV) on preoperative contrast-enhanced CT scans of adrenal venous sampling (AVS) in the era of high-resolution CT (HRCT).
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Objectives: Primary Aldosteronism (PA) is a common but under-recognised cause of secondary hypertension. Early diagnosis with targeted medical and/or surgical intervention is important to prevent irreversible end-organ damage. An Endocrine Society Clinical Practice Guideline was used to define audit standards against which to assess current United Kingdom (UK) laboratory practice.
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