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Primary aldosteronism (PA), characterized by the inappropriate and abnormal adrenal secretion of aldosterone, is the most common cause of secondary hypertension. PA has been shown to increase cardiovasular and cerebrovascular risks in comparison with essential hypertension. PA is a multi-faceted disease, which comprises unilateral forms, benefitting from surgical treatment, and bilateral forms, which are the best managed medically. PA is more frequently sporadic, but in some cases, it displays a familial transmission pattern. For these reasons, it is important to diagnose PA early on and correctly distinguish and manage its different forms. In this review, we analyze the different forms of PA, with attention on the diagnostic pathway and the genetics of the disease.
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http://dx.doi.org/10.1007/s40292-016-0151-6 | DOI Listing |
Front Endocrinol (Lausanne)
August 2025
Department of Endocrinology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Introduction: Incomplete clinical success after unilateral adrenalectomy for primary aldosteronism (PA) remains a significant challenge, often characterized by persistent hypertension despite biochemical remission.
Objective: This study aimed to develop and validate a preoperative predictive nomogram to estimate the probability of incomplete clinical success in PA patients undergoing unilateral adrenalectomy.
Materials And Methods: A retrospective analysis was conducted on 58 PA patients who underwent adrenalectomy.
Hell J Nucl Med
August 2025
Department of Nuclear Medicine, Sotiria Hospital, Athens Greece.
Clear iodine-131 (I)-6-β-iodomethyl- norcholesterol aldosterinoma finding, proven on biopsy, without prior discontinuation of spironolactone (due to high blood pressure) reveals no changes on scintigraphic sensitivity.
View Article and Find Full Text PDFCirculation
July 2025
Department of Medicine, University of Ottawa, Ottawa, ON, Canada. (M.M.S., G.L.H.).
Background: Primary aldosteronism (PA), an overt form of renin-independent aldosterone production, leads to a disproportionately high rate of major adverse cardiovascular events (MACEs). Mounting evidence suggests that milder forms of renin-independent aldosterone production (subclinical PA) are highly prevalent; however, the link between subclinical PA and MACE remains uncertain.
Methods: This prospective study included 2017 Canadian adults 40 to 69 years of age from the randomly sampled, population-based CARTaGENE cohort (Québec, Canada), in which aldosterone and renin concentrations at enrollment (2009-2010) were measured.
Endocrine
September 2025
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Purpose: Primary aldosteronism (PA) is prevalent among hypertensive patients, and associated with worsened cardiovascular outcomes compared to essential hypertension (HT). Screening and diagnostics for PA are currently complicated and invasive, why new methods are needed. Unilateral PA (uPA) is best treated surgically, and bilateral PA (bPA) - medically.
View Article and Find Full Text PDFSci Rep
May 2025
Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9-15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery.
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