Primary aldosteronism: from case detection to histopathology with up to 6 years of follow-up

J Clin Hypertens (Greenwich). 2017 Apr;19(4):424-430. doi: 10.1111/jch.12947. Epub 2016 Nov 23.

Abstract

The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long-term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007-2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling. Patients with unilateral disease were offered treatment with adrenalectomy. A total of 33 patients were diagnosed with PA during the study period: 17 patients with bilateral disease and 16 with unilateral disease. Results from salt loading test were positive in 90% of patients. In patients with adenoma, 36% were responsive on their positional test and computed tomography scan showed a nodule in 73%. All patients with unilateral disease had a lateralization index ≥3. After surgery, patients had lower systolic blood pressure (P<.001) and number of hypertensive medications (P<.01).

MeSH terms

  • Adrenal Gland Neoplasms / surgery*
  • Adrenal Glands / blood supply
  • Adrenalectomy / methods*
  • Adult
  • Aged
  • Female
  • Humans
  • Hyperaldosteronism / diagnosis*
  • Hyperaldosteronism / surgery
  • Hyperplasia
  • Hypertension / drug therapy
  • Iceland / epidemiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed