Prevalence, diagnosis and outcomes of treatment for primary aldosteronism

Best Pract Res Clin Endocrinol Metab. 2020 Mar;34(2):101365. doi: 10.1016/j.beem.2019.101365. Epub 2019 Dec 5.

Abstract

Primary aldosteronism (PA) is the most common potentially curable form of hypertension. The overproduction of aldosterone leads to an increased risk of cardiovascular and cerebrovascular events as well as adverse effects to the heart and kidney and psychological disorders. PA is mainly caused by unilateral aldosterone excess due to an aldosterone-producing adenoma or bilateral excess due to bilateral adrenocortical hyperplasia. The diagnostic work-up of PA comprises three steps: screening, confirmatory testing and differentiation of unilateral surgically-correctable forms from medically treated bilateral PA. These specific treatments can mitigate or reverse the increased risks associated with PA. Herein we summarise the prevalence, outcomes and current and future clinical approaches for the diagnosis of primary aldosteronism.

Keywords: adrenal venous sampling; aldosterone; aldosterone-producing adenoma; bilateral adrenal hyperplasia; prevalence; renin.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / epidemiology
  • Adrenal Gland Neoplasms / therapy
  • Adrenocortical Adenoma / complications
  • Adrenocortical Adenoma / diagnosis
  • Adrenocortical Adenoma / epidemiology
  • Adrenocortical Adenoma / therapy
  • Aldosterone / metabolism
  • Diagnostic Techniques, Endocrine*
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / diagnosis*
  • Hyperaldosteronism / epidemiology*
  • Hyperaldosteronism / therapy*
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Hypertension / therapy
  • Mass Screening / methods
  • Prevalence
  • Prognosis
  • Treatment Outcome

Substances

  • Aldosterone