title: [Primary hyperaldosteronisms: from diagnosis to treatment].
abstract: Primary hyperaldosteronism is a growing cause of apparently essential hypertension (until 15 % of patients with hypertension). Primary hyperaldosteronism can now be recognized even for patients without hypertension or hypokaliemia. Paradoxically normal levels of aldosterone when serum renin levels and/or plasmatic renin activity and/or kaliemia are low, lead to suggest primary hyperaldostéronism. High values of aldosterone/renin or aldosterone/PRA favour the diagnosis. Adrenal scanography (fine slices) has to be performed, and confronted with one functional procedure (adrenal iodocholestérol uptake after dexamethasone, or sampling of adrenal venous blood for aldosterone measurement) only if surgery is suggested. When hypersecretion is unilateral or largely predominant in one size, surgery is very useful, when hypertension or hypokaliemia are poorly controlled, when medications are unwell tolerated, especially in men.
authors.affiliation: Service d'endocrinologie et maladies métaboliques, Clinique endocrinologique Marc Linquette, CHU de Lille, F-59037 Lille Cedex, France. jl-wemeau@chru-lille.fr
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Wémeau
authors.forename: Claire
authors.initials: C
authors.lastname: Mounier-Vehier
authors.forename: Bruno
authors.initials: B
authors.lastname: Carnaille
authors.forename: Claire
authors.initials: C
authors.lastname: Douillard
mesh_terms: D000304:Adrenal Cortex Function Tests; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000097:blood / Q000175:diagnosis; D000450:Aldosterone / Q000097:blood; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006973:Hypertension / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007008:Hypokalemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D008297:Male; D012083:Renin / Q000097:blood
chemical_list: D000959:Antihypertensive Agents; D000450:Aldosterone; D012083:Renin