Clinical management of hyperaldosteronism

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Other

Abstract

Primary aldosteronism, or Conn’s syndrome, is a common cause of secondary hypertension with a prevalence of up to 20% in patients with resistant hypertension. It is characterized by inappropriately high aldosterone production, most commonly from a unilateral adrenal adenoma or bilateral adrenal hyperplasia. Aldosterone synthesis in primary aldosteronism is independent of the renin-angiotensin system and not suppressible by volume expansion. Beyond its effect on raising blood pressure, aldosterone excess also mediates adverse cardiovascular, renal and metabolic consequences via its actions at the mineralocorticoid receptor. Patients with hypertension that has an early onset, is difficult to control or is associated with hypokalemia or cardiac dysfunction should be screened using an aldosterone/renin ratio and subsequently confirmed with fludrocortisone or saline suppression testing. The identification of the subtype of primary aldosteronism using radiological imaging and adrenal vein sampling is also important as unilateral disease is curable by surgery. The early diagnosis and targeted treatment of primary aldosteronism with either surgery or mineralocorticoid receptor antagonists is crucial to prevent end-organ damage mediated by aldosterone excess.

Original languageEnglish
Title of host publicationAdrenal Glands: From Pathophysiology to Clinical Evidence
Subtitle of host publicationFrom Pathophysiology to Clinical Evidence
EditorsGaetano Santulli
Place of PublicationNew York NY USA
PublisherNova Science Publishers
Pages115-142
Number of pages28
ISBN (Electronic)9781634835701
ISBN (Print)9781634835503
Publication statusPublished - 1 Jan 2015
Externally publishedYes

Keywords

  • Aldosterone
  • Conn’s syndrome
  • Primary aldosteronism
  • Secondary hypertension

Cite this

Wang, J., & Fuller, P. J. (2015). Clinical management of hyperaldosteronism. In G. Santulli (Ed.), Adrenal Glands: From Pathophysiology to Clinical Evidence: From Pathophysiology to Clinical Evidence (pp. 115-142). Nova Science Publishers.