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JOURNAL ARTICLE
Hemodynamic Mechanisms Initiating Salt-Sensitive Hypertension in Rat Model of Primary Aldosteronism.
M Pravenec, P Mlejnek, M Šimáková, J Šilhavý
Few studies have investigated the hemodynamic mechanism whereby primary hyperaldosteronism causes hypertension. The traditional view holds that hyperaldosteronism initiates hypertension by amplifying salt-dependent increases in cardiac output (CO) by promoting increases in sodium retention and blood volume. Systemic vascular resistance (SVR) is said to increase only as a secondary consequence of the increased CO and blood pressure. Recently, we investigated the primary hemodynamic mechanism whereby hyperaldosteronism promotes salt sensitivity and initiation of salt-dependent hypertension...
April 18, 2024: Physiological Research
#2
JOURNAL ARTICLE
Rui Chen, Hairong Hao, Yuhong Dai, Liang Cheng, Feng Bai, Xiaoqing Wang, Wen Hu
Data on the prognosis of clinically undiagnosed hypertensive patients who are aldosterone-to-renin ratio (ARR) positive are still scarce. Therefore, we investigated the clinical characteristics of clinically undiagnosed hypertensive patients who were ARR-positive and the influence of their different treatments on the occurrence and development of complications. A total of 285 hypertensive patients data with ARR ≥ 3.8 in the Second People's Hospital of Huai'an from January 2019 to December 2021 were collected, and 135 undiagnosed hypertensive patients were ultimately included in the analysis...
April 17, 2024: Hypertension Research: Official Journal of the Japanese Society of Hypertension
#3
JOURNAL ARTICLE
Terry P Gao, Rebecca L Green, Lindsay E Kuo
INTRODUCTION: Adrenalectomy generally has favorable outcomes. It is unknown if patients with functional adrenal tumors experience different clinical outcomes than those with benign adrenal tumors, due to the presence of comorbid conditions secondary to the functional tumor. We investigated outcomes following open and laparoscopic adrenalectomy for benign nonfunctional (BNF) versus functional adrenal masses. METHODS: Patients undergoing adrenalectomy were identified in the 2015-2020 National Surgical Quality Improvement Program database, then categorized as BNF, hyperaldosteronism, hypercortisolism, and pheochromocytoma...
April 15, 2024: Journal of Surgical Research
#4
JOURNAL ARTICLE
Paolo Mulatero, Gregoire Wuerzner, Michael Groessl, Elisa Sconfienza, Aikaterini Damianaki, Vittorio Forestiero, Bruno Vogt, Hans Brunner, Teresa Gerlock, Ronald Steele, Christoph Schumacher
BACKGROUND: Primary aldosteronism (PA) is caused by autonomous aldosterone overproduction and characterised by uncontrolled hypertension. There are currently no treatments that target aldosterone synthesis. We evaluated the safety and efficacy of a novel aldosterone synthase inhibitor, dexfadrostat phosphate, in patients with PA. METHODS: This multi-centre, randomised, phase 2 trial was conducted between November 2019 and May 2022 (NCT04007406; EudraCT code 2019-000919-85)...
May 2024: EClinicalMedicine
#5
Juyoung Pak, Hyoung Nam Lee, Myung Sub Kim, Hyerim Park
Primary aldosteronism is a group of disorders in which the autonomous secretion of aldosterone is associated with hypertension and hypokalemia. It is crucial to determine the laterality of aldosterone hypersecretion because treatment options differ accordingly. Adrenal venous sampling (AVS) is considered the most reliable method for assessing the laterality of primary aldosteronism. This procedure is often technically challenging because of the small size and varied locations of the adrenal veins. A better understanding of anatomical variations and careful review of imaging studies would improve sampling success...
March 2024: J Korean Soc Radiol
#6
JOURNAL ARTICLE
Chineme Onwubueke, Saif M Borgan, Huijun Xiao, Keren Zhou
In patients with primary hyperaldosteronism (PA), adrenal vein sampling (AVS) can identify patients suitable for unilateral adrenalectomy. However, in AVS with an indeterminate aldosterone-to-cortisol lateralization (ACL) ratio of 3.0-4.0, clinical guidance is unclear. The authors screened all patients undergoing AVS at the Cleveland Clinic from October 2010 to January 2021 and identified 18 patients with indeterminate ACL results. Ten underwent adrenalectomy and eight continued medical management. The surgical group was younger (58...
April 11, 2024: Journal of Clinical Hypertension
#7
JOURNAL ARTICLE
Akira Ikeya, Miho Yamashita, Keisuke Kakizawa, Yuto Kawauchi, Akio Matsushita, Yasuko Fujisawa, Tsutomu Ogata, Shigekazu Sasaki
17α-hydroxylase deficiency is a type of congenital adrenocortical hyperplasia that is typically diagnosed in childhood or adolescence. It manifests as hypertension with gonadal dysfunction as the primary symptom. We herein report 17α-hydroxylase/17,20-lyase deficiency (17OHD) diagnosed at the age of 45 years. The patient presented with hypertension, irregular menstruation, and hyperaldosteronism. The clinical manifestations of 17OHD vary based on the specific variant pattern of CYP17A1. In this case, the variant was c...
April 9, 2024: Internal Medicine
#8
JOURNAL ARTICLE
Paolo Mulatero, Ute I Scholl, Carlos E Fardella, Evangelia Charmandari, Andrzej Januszewicz, Martin Reincke, Celso E Gomez-Sanchez, Michael Stowasser, Olaf M Dekkers
We describe herein the European Reference Network on Rare Endocrine Conditions (Endo-ERN)- clinical practice guideline on diagnosis and management of familial forms of hyperaldosteronism. The guideline panel consisted of 10 experts in primary aldosteronism, endocrine hypertension, pediatric endocrinology and cardiology as well as a methodologist. A systematic literature search was conducted, and because of the rarity of the condition, most recommendations were based on expert opinion and small patient series...
April 4, 2024: European Journal of Endocrinology
#9
JOURNAL ARTICLE
Jorge Gabriel Ruiz-Sánchez, Álvaro Fernández Sánchez, Diego Meneses
PURPOSE: Primary aldosteronism (PA), a frequent cause of hypertension, is highly associated with cardiovascular risk and mortality. PA diagnosis is often difficult due to the need to discontinue antihypertensive medication interfering with the renin-angiotensin-aldosterone system (I-RAAS). Our objective was to ascertain diagnosis of PA through biochemical assessments during screening while maintaining I-RAAS medications. METHODS: Hypertensive patients assessed for PA were involved...
April 3, 2024: Endocrine
#10
JOURNAL ARTICLE
Giselle Fernandes Taboada, Aline Barbosa Moraes, Leonardo Vieira
OBJECTIVE: Despite its recognized importance, primary hyperaldosteronism (PHA) remains an underdiagnosed condition in clinical practice. The objective of the present study was to evaluate PHA screening practices by general practitioners and specialists in endocrinology and cardiology. SUBJECTS AND METHODS: This cross-sectional, observational study invited physicians to respond voluntarily to an online survey. The survey collected the respondents' sociodemographic data and answers to five hypothetical clinical cases meeting Endocrine Society criteria for PHA screening...
March 15, 2024: Archives of Endocrinology and Metabolism
#11
JOURNAL ARTICLE
Michaela Javorkova, Andrea Bystricanova, Martina Cirbusova, Marcela Cvoligova, Martin Chrastina, Juraj Maris, Janka Otavkova, Zuzana Zilinska
Conn's syndrome, defined as unilateral aldosterone-producing adenoma, accounts for 35-40% of cases of primary hyperaldosteronism. Primary hyperaldosteronism typically occurs in younger patients with poorly controlled arterial hypertension due to extracellular fluid retention, in whom at least a triple combination of antihypertensives, including a diuretic, is needed to maintain normotension. The clinical picture of arterial hypertension may be complemented by symptoms associated with hypokalaemia, such as weakness, fatigue, palpitations, convulsions, polydipsia, or polyuria...
2024: Bratislavské Lekárske Listy
#12
JOURNAL ARTICLE
Elle C J van de Wiel, Janneke Mulder, Anke Hendriks, Ingeborg Booij Liewes-Thelosen, Xiaoye Zhu, Hans Groenewoud, Peter F A Mulders, Jaap Deinum, Johan F Langenhuijsen
PURPOSE: No data exist on perioperative strategies for enhancing recovery after posterior retroperitoneoscopic adrenalectomy (PRA). Our objective was to determine whether a multimodality adrenal fast-track and enhanced recovery (AFTER) protocol for PRA can reduce recovery time, improve patient satisfaction and maintain safety. METHODS: Thirty primary aldosteronism patients were included. Fifteen patients were treated with 'standard-of-care' PRA and compared with 15 in the AFTER protocol...
March 22, 2024: World Journal of Urology
#13
JOURNAL ARTICLE
Wen-Yu Ho, Ching-Chung Hsiao, Ping-Hsun Wu, Jui-Yi Chen, Yu-Kang Tu, Vin-Cent Wu, Jia-Jin Chen
BACKGROUND: The effectiveness and side effects between different medical treatments in patients with primary hyperaldosteronism have not been systematically studied. OBJECTIVE: To analyze the efficacy between different mineralocorticoid receptor antagonists (MRAs) and epithelial sodium channel (ENaC) inhibitors in a network meta-analysis (NMA) framework, while also evaluating adverse events. DESIGN: Systematic review and NMA. DATA SOURCES AND METHODS: The systematic review and NMA was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
2024: Therapeutic Advances in Chronic Disease
#14
REVIEW
Jenifer M Brown
Aldosterone is a steroid hormone that primarily acts through activation of the mineralocorticoid receptor (MR), a nuclear receptor responsible for downstream genomic regulation. Classically, activation of the MR in the renal tubular epithelium is responsible for sodium retention and volume expansion, raising systemic blood pressure. However, activation of the MR across a wide distribution of tissue types has been implicated in multiple adverse consequences for cardiovascular, cerebrovascular, renal, and metabolic disease, independent of blood pressure alone...
March 18, 2024: Journal of the American Heart Association
#15
REVIEW
Marta Araujo-Castro, Paola Parra, Patricia Martín Rojas-Marcos, Miguel Paja Fano, Marga González Boillos, Eider Pascual-Corrales, Ana María García Cano, Jorge Gabriel Ruiz-Sanchez, Almudena Vicente Delgado, Emilia Gómez Hoyos, Rui Ferreira, Iñigo García Sanz, Mònica Recasens Sala, Rebeca Barahona San Millan, María José Picón César, Patricia Díaz Guardiola, Carolina M Perdomo, Laura Manjón-Miguélez, Rogelio García Centeno, Ángel Rebollo Román, Paola Gracia Gimeno, Cristina Robles Lázaro, Manuel Morales-Ruiz, María Calatayud, Simone Andree Furio Collao, Diego Meneses, Miguel Sampedro Nuñez, Verónica Escudero Quesada, Elena Mena Ribas, Alicia Sanmartín Sánchez, Cesar Gonzalvo Diaz, Cristina Lamas, María Del Castillo Tous, Joaquín Serrano Gotarredona, Theodora Michalopoulou Alevras, Eva María Moya Mateo, Felicia A Hanzu
PURPOSE: To compare the clinical and hormonal characteristics of patients with familial hyperaldosteronism (FH) and sporadic primary aldosteronism (PA). METHODS: A systematic review of the literature was performed for the identification of FH patients. The SPAIN-ALDO registry cohort of patients with no suspicion of FH was chosen as the comparator group (sporadic group). RESULTS: A total of 360 FH (246 FH type I, 73 type II, 29 type III, and 12 type IV) cases and 830 sporadic PA patients were included...
2024: Frontiers in Endocrinology
#16
JOURNAL ARTICLE
Utku Soyaltin
PURPOSE: In patients with bilateral primary hyperaldosteronism (PA) and those with unilateral PA who are unwilling or unable to undergo adrenalectomy an increase in plasma renin activity (PRA) provided by mineralocorticoid receptor antagonists (MRAs) therapy reflects sufficient antagonism for elevated aldosterone. Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have cardiovascular, renal protective properties and some clinical data have shown an increase in PRA levels with SGLT2-i...
March 11, 2024: Blood Pressure Monitoring
#17
EDITORIAL
Aleksander Prejbisz, Piotr Dobrowolski
No abstract text is available yet for this article.
February 26, 2024: Journal of Clinical Endocrinology and Metabolism
#18
Natália Diel Boufleuer, Dimitris V Rados, Tatiana Zambonato, Clara K Maraschin, Beatriz D Schaan
INTRODUCTION: The triad of hypercalcemia, metabolic alkalosis, and acute kidney injury associated with ingesting high doses of calcium and absorbable bases characterizes the calcium-alkali syndrome. Clinical Case . We report the case of a patient with postthyroidectomy hypoparathyroidism 15 years ago due to differentiated thyroid cancer who presented with severe hypercalcemia. He had adequate control of calcemia for many years on treatment with calcitriol and calcium carbonate and hypertension treated with amlodipine, losartan, and hydrochlorothiazide...
2024: Case Reports in Endocrinology
#19
JOURNAL ARTICLE
Ping Qiu, Li Zang, Li Zhang, Zhaohui Lyu, Yiming Mu, Qinghua Guo
OBJECTIVE: To compare the diagnostic value of adrenocorticotropic hormone (ACTH) stimulation test (AST) with different doses of ACTH combined with midnight administration of 1 mg dexamethasone for the determination of the subtypes of primary hyperaldosteronism (PA). METHODS: This is a prospective observational study. Patients diagnosed with PA in the Department of Endocrinology, the First Medical Center of of Chinese PLA General Hospital from January 1, 2020 to September 30, 2022 underwent AST with different doses of ACTH...
January 20, 2024: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
#20
JOURNAL ARTICLE
Martina Tetti, Denise Brüdgam, Jacopo Burrello, Aaron M Udager, Anna Riester, Thomas Knösel, Felix Beuschlein, William E Rainey, Martin Reincke, Tracy Ann Williams
BACKGROUND: Primary aldosteronism (PA) is frequently caused by a unilateral aldosterone-producing adenoma with a PA-driver mutation. Unilateral adrenalectomy has a high probability of short-term biochemical remission, but long-term postsurgical outcomes are relatively undefined. Our objective was to investigate the incidence of long-term recurrence of PA in individuals with postsurgical short-term biochemical remission. METHODS: Adrenalectomized patients for unilateral PA were included from a single referral center...
February 6, 2024: Hypertension
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