title: Primary hyperaldosteronism diagnosed with adrenal vein sampling. Characteristics and follow-up after adrenalectomy in a Danish study.
abstract: BACKGROUND
  Primary hyperaldosteronism (PA), known as Mb Conn, is one of the most common forms of secondary hypertension in middle-aged adults. High plasma aldosterone has been associated with severe organ damage. The unilateral aldosterone-producing adenoma (lateralized disease) is a subtype of PA, which can be fully or partly cured by adrenalectomy.
  
  
  METHODS
  Retrospective review of data from 50 patients who underwent adrenal venous sampling (AVS) was performed. Medical records, plasma renin and aldosteron, confirmatory tests and medical imaging (predominantly Computed Tomography and Magnetic Resonance Imaging) were available. Patients with lateralized disease (n = 39) underwent adrenalectomy and additional clinical data at least one year after surgery was recorded.
  
  
  RESULTS
  Age and gender were widely and equally distributed (median age = 51, age span = 28-73). Patients with lateralized disease had higher blood pressure (BP) and lower serum potassium compared to patients with bilateral hyperplasia. No difference regarding age and gender distribution was detected. Despite lateralized disease diagnosed from AVS, the medical images were normal in 10 patients (28%). Follow-up of 30 patients who underwent adrenalectomy showed that six patients were cured, 17 had better BP control, five patients had no effect and one patient had higher BP but decreased number of antihypertensive drugs.
  
  
  CONCLUSIONS
  PA is of equal prevalence in men and women, young and old individuals. The agreement between imaging modalities and AVS is limited, and the final diagnosis must rely on AVS. Patients prone for surgery had better BP control after adrenalectomy.
authors.affiliation: a Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital , University of Copenhagen , Herlev and.
authors.forename: Maria
authors.initials: M
authors.lastname: Pedersen
authors.affiliation: b Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital , University of Copenhagen , Glostrup , Denmark.
authors.forename: Mona A
authors.initials: MA
authors.lastname: Karlsen
authors.affiliation: b Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital , University of Copenhagen , Glostrup , Denmark.
authors.forename: Kasper L
authors.initials: KL
authors.lastname: Ankjærgaard
authors.affiliation: a Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital , University of Copenhagen , Herlev and.|b Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital , University of Copenhagen , Glostrup , Denmark.
authors.forename: Lars T
authors.initials: LT
authors.lastname: Jensen
mesh_terms: D000236:Adenoma / Q000097:blood / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy / Q000379:methods*; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D012189:Retrospective Studies; D014680:Veins
chemical_list: D000450:Aldosterone; D012083:Renin; D011188:Potassium
keywords: Hypertension; adrenal cortex; adrenocortical adenoma; aldosterone; endocrinology