: Primary aldosteronism is a frequent cause of secondary hypertension requiring a specific pharmacological treatment with mineralocorticoid receptor antagonist or with unilateral adrenalectomy. These treatments have shown to reduce the excess of cardiovascular risk characteristically associated with this disease. In part I of this consensus, we discussed the procedures for the diagnosis of primary aldosteronism. In the present part II, we address the strategies for the differential diagnosis of primary aldosteronism subtypes and therapy. We also discuss the evaluation of outcomes and provide suggestions for follow-up as well as cardiovascular and metabolic complications specifically associated with primary aldosteronism. Finally, we analyse the principal gaps of knowledge and future challenges for research in this field.
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http://dx.doi.org/10.1097/HJH.0000000000002520 | DOI Listing |
J Surg Res
December 2024
Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:
Introduction: Primary aldosteronism affects 20% of patients with resistant hypertension and may be due to unilateral or bilateral causes. Patients with a unilateral source of aldosterone secretion are potentially curable with adrenalectomy. Adrenal vein sampling (AVS) is the definitive test for subtype differentiation but may not be accessible outside tertiary centers.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Health and Care Professions, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.;
Background/aim: Transient ischaemic attack (TIA) is characterised by a temporary neurological dysfunction resulting from focal ischaemia in the brain, spinal cord or retina without acute infarction. These episodes typically last less than 24 hours and are significant predictors of subsequent ischaemic strokes. Hypertension is a major risk factor for cerebrovascular events, and primary aldosteronism (PA) is recognised as a common cause of secondary hypertension.
View Article and Find Full Text PDFJ Vasc Interv Radiol
December 2024
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Purpose: To evaluate the impact of corticosteroid premedication on the performance of adrenal vein sampling (AVS) in patients with primary aldosteronism (PA) and allergy to iodinated contrast media (ICM).
Materials And Methods: Patients who underwent AVS for PA, between September 1990 and October 2023, were retrospectively identified. Patients with ICM allergy who received corticosteroid pre-medication were matched 1:1 with patients without contrast allergy.
Case Rep Endocrinol
December 2024
Department of Interventional Radiology, Oregon Health and Science University, Portland, Oregon, USA.
We report a case of successfully lateralized adrenal cortisol hypersecretion by adrenal venous sampling (AVS) and improved by surgery. AVS is a commonly used tool to guide surgical management of primary hyperaldosteronism. It can determine lateralization, leading to unilateral adrenalectomies of the correct side, or nonlateralization, which precludes surgery.
View Article and Find Full Text PDFTher Adv Chronic Dis
December 2024
Monash University, Clayton, VIC, Australia.
Background: Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension and can be effectively managed, or even cured, with targeted treatment. Despite this, it remains largely undiagnosed leaving a significant patient population with resistant hypertension and modifiable cardiovascular risk.
Objective: To determine expert consensus on key information about PA that should ideally be taught to medical students as a step toward improving the detection of this common, underdiagnosed, and often easily treated condition.
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