title: Diagnosing and Managing Primary Aldosteronism in Hypertensive Patients: a Case-Based Approach.
abstract: Primary aldosteronism with a prevalence of 8 % of hypertension and 20 % of pharmacologically resistant hypertension is the most common secondary cause of hypertension. Yet, the diagnosis is missed in the vast majority of patients. Current clinical practice guidelines recommend screening for primary aldosteronism in patients with sustained elevation of blood pressure (BP) ≥150/100 mmHg if possible prior to initiation of antihypertensive therapy, and in patients with resistant hypertension, spontaneous or diuretic-induced hypokalemia, adrenal incidentaloma, obstructive sleep apnea, a family history of early onset of hypertension or cerebrovascular accident <age 40, and first-degree relatives of patients with primary aldosteronism. Clinical and laboratory methods of screening, confirmatory testing, subtype classification, and medical and surgical management are systematically reviewed and illustrated with a clinical case.
authors: Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, P.O. Box 801414, Charlottesville, VA, 22908-1414, USA. rmc4c@virginia.edu.
authors: Robert M
authors: RM
authors: Carey
mesh_terms: D000315:Adrenalectomy; D000077545:Eplerenone; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D007008:Hypokalemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D010535:Laparoscopy; D008403:Mass Screening / Q000379:methods; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone
keywords: Aldosterone; Hypertension; Laparoscopic adrenalectomy; Mineralocorticoid receptor antagonist; Primary aldosteronism