title: Primary Aldosteronism: Diagnosis and Management.
abstract: Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Localization to determine adrenal gland involvement is done by imaging, with computerized tomography or magnetic resonance imaging. After imaging, adrenal vein sampling is done to establish treatment options. Patients with unilateral disease, who are good surgical candidates, are most appropriately managed with adrenalectomy. A biochemical cure is almost certain following adrenalectomy; however, only 30-50% of patients would show adequate blood pressure improvement. Patients with bilateral adrenal disease and those believed not to be surgical candidates are managed with mineralocorticoid antagonists.
authors: Nephrology Section, Veterans Affairs Medical Center, Memphis, Tennessee; Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee. Electronic address: docgeeta@yahoo.com.
authors: Geeta
authors: G
authors: Gyamlani
authors: Nephrology Section, Veterans Affairs Medical Center, Memphis, Tennessee.
authors: Carol M
authors: CM
authors: Headley
authors: Nephrology Section, Veterans Affairs Medical Center, Memphis, Tennessee; Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee.
authors: Adnan
authors: A
authors: Naseer
authors: Department of Surgery, Veterans Affairs Medical Center, Memphis, Tennessee; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
authors: Ganpat S
authors: GS
authors: Valaulikar
authors: Department of Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
authors: Stephen A
authors: SA
authors: Geraci
mesh_terms: D019468:Disease Management; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000175:diagnosis* / Q000628:therapy
keywords: Diagnosis; Hypertension; Outcome; Primary aldosteronism; Treatment