Diagnosis and treatment of primary aldosteronism: practical clinical perspectives

@article{Young2019DiagnosisAT,
  title={Diagnosis and treatment of primary aldosteronism: practical clinical perspectives},
  author={William F Young},
  journal={Journal of Internal Medicine},
  year={2019},
  volume={285},
  pages={126 - 148}
}
  • W. Young
  • Published 25 September 2018
  • Medicine, Biology
  • Journal of Internal Medicine
Primary aldosteronism (PA), the most common form of secondary hypertension, can be either surgically cured or treated with targeted pharmacotherapy. PA is frequently undiagnosed and untreated, leading to aldosterone‐specific cardiovascular morbidity and nephrotoxicity. Thus, clinicians should perform case detection testing for PA at least once in all patients with hypertension. Confirmatory testing is indicated in most patients with positive case detection testing results. The next step is to… 

[Primary aldosteronism: The Mayo Clinic approach].

TLDR
Mayo Clinic approach is aimed to simplify primary case detection testing for PA, and in patients with bilateral aldosterone hypersecretion, the optimal is a low-sodium diet and lifelong treatment with a mineralocorticoid receptor antagonist administered at a dosage to reach a high-normal serum potassium concentration.

Therapeutic Outcomes with Surgical and Medical Management of Primary Aldosteronism

TLDR
Adrenalectomy is the most effective treatment for unilateral PA, and biomarkers for MRA therapy might inform optimal medical therapy of bilateral adrenal hyperplasia.

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  • J. Funder
  • Medicine, Biology
    Best practice & research. Clinical endocrinology & metabolism
  • 2019

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TLDR
An illustrative case of primary aldosteronism diagnosed in the setting of CKD is presented with subsequent review of the literature and some recent developments in PA diagnostic strategies particularly applicable to the CKD population are discussed.

Prevalence, diagnosis and outcomes of treatment for primary aldosteronism.

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  • G. Hundemer
  • Medicine, Biology
    Current Cardiology Reports
  • 2019
TLDR
This review synthesizes recent research findings regarding cardiovascular disease risk in PA both pre- and post-targeted therapy to optimize long-term cardiovascular outcomes.

Diagnosis and treatment of aldosterone-producing adenoma in a young patient: a clinical case

TLDR
A clinical case of a 32 year old male patient, who despite the full clinical picture of PHA, was managed in primary care setting with the diagnosis of myalgia and treatment-resistant arterial hypertension, and a simplified diagnostic algorithm was successfully applied in the patient.

Adrenal venous sampling in young patients with primary aldosteronism. Extravagance or irreplaceable?

TLDR
The results support AVS for subtype evaluation in young adults with PA, including patients 35 years or younger, in contrast to current clinical guidelines.

Normotensive presentation in primary aldosteronism: A report of two cases

TLDR
All patients with hypokalemia should be screened for PA in order to prevent cardiovascular complications while balancing economics and effectiveness, as hypertension is not necessarily a sign of PA.

Pathogenesis and treatment of primary aldosteronism

TLDR
The genetic abnormalities associated with sporadic and familial forms of primary aldosteronism, their frequency among different populations and the mechanisms explaining excessive aldosterone production and adrenal nodule development are provided.
...

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