Diagnosis of primary aldosteronism: from screening to subtype differentiation.
Numerous studies conducted in recent years have reported an increase in the prevalence of primary aldosteronism (PA). This increase has arisen because of changes in our screening methods used to detect PA, notably the widespread use of the ratio of plasma aldosterone concentration to plasma renin activity. A positive screening result, however, is not diagnostic and requires a confirmatory test. Strategies for screening and confirmation of PA and the techniques to identify the two main subtypes of PA--aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH)--are particularly important because hypertension in APA can be cured by adrenalectomy, whereas individuals affected with BAH can receive targeted medical treatment with mineralocorticoid receptor antagonists.
Mulatero
Paolo
P
Department of Medicine and Experimental Oncology, Hypertension Unit, University of Turin, Turin 10133, Italy.
Dluhy
Robert G
RG
Giacchetti
Gilberta
G
Boscaro
Marco
M
Veglio
Franco
F
Stewart
Paul M
PM
D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D000307:Adrenal Gland Diseases / Q000175:diagnosis*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D000450:Aldosterone / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis*
D000450:Aldosterone