title: Primary hyperaldosteronism associated with hypertensive emergencies.
abstract: There is growing awareness of primary hyperaldosteronism as a cause of secondary hypertension. Usually, it manifests as hypertension and hypokalemia, or as resistant hypertension. Much less often, primary hyperaldosteronism may be detected after a hypertensive emergency has developed. We highlight this association by reporting on eight patients with a clinical diagnosis of primary hyperaldosteronism whose course was complicated by a hypertensive crisis. In all patients, an elevated serum aldosterone, was accompanied by a suppressed plasma renin activity despite the presence of a hypertensive crisis. A good outcome was obtained either with laparoscopic adrenalectomy (1 patient) or with an antihypertensive drug regimen that included an antialdosterone agent (7 patients). The differential diagnosis of hypertensive emergencies should include primary hyperaldosteronism.
authors.affiliation: Section of Hypertension, Pat and Jim Calhoun Center for Cardiology, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Labinson
authors.forename: William B
authors.initials: WB
authors.lastname: White
authors.forename: Beatriz E
authors.initials: BE
authors.lastname: Tendler
authors.forename: George A
authors.initials: GA
authors.lastname: Mansoor
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone; D012083:Renin; D011188:Potassium