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Minireview: primary aldosteronism--changing concepts in diagnosis and treatment.
Endocrinology. 2003 Jun; 144(6):2208-13.E

Abstract

Primary aldosteronism affects 5-13% of patients with hypertension. Patients with hypertension and hypokalemia and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism with a plasma aldosterone concentration to plasma renin activity ratio. A high plasma aldosterone concentration to plasma renin activity ratio is a positive screening test result, a finding that warrants confirmatory testing. For those patients that want to pursue a surgical cure, the accurate distinction between the subtypes (unilateral vs. bilateral adrenal disease) of primary aldosteronism is a critical step. The subtype evaluation may require one or more tests, the first of which is imaging the adrenal glands with computed tomography, followed by selective use of adrenal venous sampling. Because of the deleterious cardiovascular effects of aldosterone, normalization of circulating aldosterone or aldosterone receptor blockade should be part of the management plan for all patients with primary aldosteronism. Unilateral laparoscopic adrenalectomy is an excellent treatment option for patients with unilateral aldosterone-producing adenoma. Bilateral idiopathic hyperaldosteronism should be treated medically. In addition, aldosterone-producing adenoma patients may be treated medically if the medical treatment includes mineralocorticoid receptor blockade.

Authors+Show Affiliations

Mayo Medical School, Rochester, Minnesota 55905, USA. Young.William@Mayo.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12746276

Citation

Young, William F.. "Minireview: Primary Aldosteronism--changing Concepts in Diagnosis and Treatment." Endocrinology, vol. 144, no. 6, 2003, pp. 2208-13.
Young WF. Minireview: primary aldosteronism--changing concepts in diagnosis and treatment. Endocrinology. 2003;144(6):2208-13.
Young, W. F. (2003). Minireview: primary aldosteronism--changing concepts in diagnosis and treatment. Endocrinology, 144(6), 2208-13.
Young WF. Minireview: Primary Aldosteronism--changing Concepts in Diagnosis and Treatment. Endocrinology. 2003;144(6):2208-13. PubMed PMID: 12746276.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minireview: primary aldosteronism--changing concepts in diagnosis and treatment. A1 - Young,William F,Jr PY - 2003/5/15/pubmed PY - 2003/6/26/medline PY - 2003/5/15/entrez SP - 2208 EP - 13 JF - Endocrinology JO - Endocrinology VL - 144 IS - 6 N2 - Primary aldosteronism affects 5-13% of patients with hypertension. Patients with hypertension and hypokalemia and most patients with treatment-resistant hypertension should undergo screening for primary aldosteronism with a plasma aldosterone concentration to plasma renin activity ratio. A high plasma aldosterone concentration to plasma renin activity ratio is a positive screening test result, a finding that warrants confirmatory testing. For those patients that want to pursue a surgical cure, the accurate distinction between the subtypes (unilateral vs. bilateral adrenal disease) of primary aldosteronism is a critical step. The subtype evaluation may require one or more tests, the first of which is imaging the adrenal glands with computed tomography, followed by selective use of adrenal venous sampling. Because of the deleterious cardiovascular effects of aldosterone, normalization of circulating aldosterone or aldosterone receptor blockade should be part of the management plan for all patients with primary aldosteronism. Unilateral laparoscopic adrenalectomy is an excellent treatment option for patients with unilateral aldosterone-producing adenoma. Bilateral idiopathic hyperaldosteronism should be treated medically. In addition, aldosterone-producing adenoma patients may be treated medically if the medical treatment includes mineralocorticoid receptor blockade. SN - 0013-7227 UR - https://www.unboundmedicine.com/medline/citation/12746276/Minireview:_primary_aldosteronism__changing_concepts_in_diagnosis_and_treatment_ L2 - https://academic.oup.com/endo/article-lookup/doi/10.1210/en.2003-0279 DB - PRIME DP - Unbound Medicine ER -
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