keyword
https://read.qxmd.com/read/38134306/prolonged-hypokalemia-and-delayed-diagnosis-of-primary-aldosteronism-clinical-course-and-risk-factors
#21
JOURNAL ARTICLE
Gaytri Gupta, Ada E D Teo, Du Soon Swee, Lih Ming Loh, Matthew Chuah, Wann Jia Loh, Seyed Ehsan Saffari, Xuan Han Koh, Peng Chin Kek, Troy H Puar
INTRODUCTION: Primary Aldosteronism (PA) is a common cause of hypertension. However, diagnosis is often delayed, leading to poorer clinical outcomes. Hypokalemia with hypertension is characteristic of PA, and is an indication for screening. We evaluated if patients with PA had prolonged hypokalemia before diagnosis, the subsequent biochemical/clinical control, and factors associated with delayed diagnosis. METHODS: Our study included all PA patients with hypokalemia diagnosed between 2001 to 2022...
December 22, 2023: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/38127970/correlation-of-histopathologic-subtypes-of-primary-aldosteronism-with-clinical-phenotypes-and-postsurgical-outcomes
#22
JOURNAL ARTICLE
Chang Ho Ahn, You-Bin Lee, Jae Hyeon Kim, Young Lyun Oh, Jung Hee Kim, Kyeong Cheon Jung
CONTEXT: Clinical implications of unilateral primary aldosteronism (PA) histopathology remain to be determined in various ethnic populations. OBJECTIVE: We examined the histopathology of unilateral PA using CYP11B2 immunostaining in relation to clinical phenotypes and postsurgical outcomes. METHODS: Patients consecutively operated for unilateral PA from 2010 to 2020 at three tertiary hospitals in South Korea were retrospectively enrolled. Adrenals with solitary aldosterone-producing adenomas and/or dominant aldosterone-producing nodules were classified as the classical and the others as the nonclassical groups...
December 21, 2023: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/38123759/water-and-electrolyte-content-in-salt-dependent-hypertension-in-the-skin-whyski-effect-of-surgical-cure-of-primary-aldosteronism
#23
JOURNAL ARTICLE
Francesca Torresan, Federico Bernardo Rossi, Sofia Zanin, Ilaria Caputo, Brasilina Caroccia, Maurizio Iacobone, Gian Paolo Rossi
UNLABELLED:  INTRODUCTION: This study will test the hypothesis that primary aldosteronism (PA) involves alterations in Na+ , K+ , and water content in the skin that are corrected by adrenalectomy. AIM AND METHODS: In skin biopsies, we will measure the content of Na+ , K+ , water, by physical-chemical methods and the osmotic-stress-responsive transcription factor Tonicity-responsive Enhancer Binding Protein (TonEBP, NFAT5) mRNA copy number by droplet digital PCR, in sex-balanced cohorts of 18 -75-year-old consecutive consenting patients with unilateral and bilateral PA, primary (essential) hypertension, and normotension...
December 21, 2023: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://read.qxmd.com/read/38095087/diagnostic-delay-and-disease-burden-in-primary-aldosteronism-an-international-patient-survey
#24
JOURNAL ARTICLE
Roshan A Ananda, Stella May Gwini, Katrina M Long, Jordan H Lai, Gang Chen, Grant M Russell, Michael Stowasser, Peter J Fuller, Jun Yang
BACKGROUND: Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS: We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022...
December 14, 2023: Hypertension
https://read.qxmd.com/read/38088428/reversal-of-arterial-stiffness-in-medically-and-surgically-treated-unilateral-primary-aldosteronism
#25
JOURNAL ARTICLE
Zheng-Wei Chen, Che-Wei Liao, Chien-Ting Pan, Cheng-Hsuan Tsai, Yi-Yao Chang, Chin-Chen Chang, Bo-Ching Lee, Yu-Wei Chiu, Wei-Chieh Huang, Tai-Shuan Lai, Ching-Chu Lu, Jeff S Chueh, Vin-Cent Wu, Chi-Sheng Hung, Yen-Hung Lin
OBJECTIVE: Hyperaldosteronism has adverse effects on cardiovascular structure and function. Laparoscopic adrenalectomy is the gold standard for patients with unilateral primary aldosteronism. For unilateral primary aldosteronism patients unable or unwilling to undergo surgery, the effects of mineralocorticoid receptor antagonists (MRAs) on the reversibility of arterial stiffness and other clinical data remain unclear. We aimed to compare the reversibility of arterial stiffness using pulse wave velocity (PWV) and other clinical parameters between surgically and medically treated unilateral primary aldosteronism patients...
December 8, 2023: Journal of Hypertension
https://read.qxmd.com/read/38087188/comparisons-of-risk-factors-for-post-treatment-renal-dysfunction-between-the-two-major-subtypes-of-primary-aldosteronism
#26
JOURNAL ARTICLE
Daisuke Watanabe, Satoshi Morimoto, Noriko Morishima, Atsuhiro Ichihara
OBJECTIVE: Aldosterone-producing adenoma (APA) and bilateral idiopathic hyperaldosteronism (IHA) are the most common subtypes of primary aldosteronism (PA), and the PA subtype dictates the treatment options. This study aimed to identify predictors of declined estimated glomerular filtration rate (eGFR) following each treatment in patients with APA and IHA. METHODS: We retrospectively investigated 45 patients with APA who had undergone adrenalectomy (ADX) and 37 patients with IHA who had received treatment with a mineralocorticoid receptor antagonist (MRA) to identify pre-treatment risk factors for eGFR decline during the post-treatment follow-up period...
December 12, 2023: Endocrine
https://read.qxmd.com/read/38073240/-primary-aldosteronism-without-hypertension-a-case-report-and-review-of-the-literature
#27
JOURNAL ARTICLE
Yves Dimitrov, Julien Ott, Lisa Beguin, Brieuc Muller
We describe the case of a patient who presented with hyperaldosteronism without arterial hypertension. She had been referred for consultation for persistent severe hypokalaemia despite oral KCl supplementation. The absence of hypertension had been proven by repeated clinical measurements and by ABPM. Hyperaldosteronism had been demonstrated by hormonal assays and catheterization of the adrenal veins. Abdominal CT revealed a left adrenal adenoma. Finally, the anatomopathological examination of the surgical specimen confirmed the adenoma...
December 11, 2023: Néphrologie & Thérapeutique
https://read.qxmd.com/read/38053266/a-modified-single-catheter-approach-for-improving-adrenal-venous-sampling-in-patients-with-primary-aldosteronism
#28
JOURNAL ARTICLE
Jindong Wan, Xinquan Wang, Sen Liu, Jixin Hou, Peng Zhou, Qiang Xue, Peijian Wang
OBJECTIVES: Adrenal vein sampling (AVS) is an established procedure for assessing subtype patients with primary aldosteronism (PA). However, it is technically challenging, with high failure rates, which limits its application in clinical practice. Our study aimed to evaluate the safety and efficacy of a single-catheter modified approach for AVS. METHODS: The clinical, angiographic, and procedural data of 182 consecutive patients who underwent AVS procedures between May 2020 and May 2023 were collected and analyzed...
December 5, 2023: Journal of Vascular Access
https://read.qxmd.com/read/38042624/machine-learning-model-with-computed-tomography-radiomics-and-clinicobiochemical-characteristics-predict-the-subtypes-of-patients-with-primary-aldosteronism
#29
JOURNAL ARTICLE
Po-Ting Chen, Pei-Yan Li, Kao-Lang Liu, Vin-Cent Wu, Yen-Hung Lin, Jeff S Chueh, Chung-Ming Chen, Chin-Chen Chang
RATIONALE AND OBJECTIVES: Adrenal venous sampling (AVS) is the primary method for differentiating between primary aldosterone (PA) subtypes. The aim of study is to develop prediction models for subtyping of patients with PA using computed tomography (CT) radiomics and clinicobiochemical characteristics associated with PA. MATERIALS AND METHODS: This study retrospectively enrolled 158 patients with PA who underwent AVS between January 2014 and March 2021. Neural network machine learning models were developed using a two-stage analysis of triple-phase abdominal CT and clinicobiochemical characteristics...
December 1, 2023: Academic Radiology
https://read.qxmd.com/read/38031887/subclinical-primary-aldosteronism-and-cardiovascular-health-a-population-based-cohort-study
#30
JOURNAL ARTICLE
Gregory L Hundemer, Mohsen Agharazii, François Madore, Anand Vaidya, Jenifer M Brown, Alexander A Leung, Gregory A Kline, Eric Larose, Marie-Eve Piché, Andrew M Crean, Julie L V Shaw, Tim Ramsay, Bernhard Hametner, Siegfried Wassertheurer, Manish M Sood, Swapnil Hiremath, Marcel Ruzicka, Rémi Goupil
BACKGROUND: Primary aldosteronism, characterized by overt renin-independent aldosterone production, is a common but underrecognized form of hypertension and cardiovascular disease. Growing evidence suggests that milder and subclinical forms of primary aldosteronism are highly prevalent, yet their contribution to cardiovascular disease is not well characterized. METHODS: This prospective study included 1284 participants between the ages of 40 and 69 years from the randomly sampled population-based CARTaGENE cohort (Québec, Canada)...
January 9, 2024: Circulation
https://read.qxmd.com/read/38013303/liddle-syndrome-presenting-with-normal-aldosterone-levels-a-case-report
#31
JOURNAL ARTICLE
Rongrong Wang, Yan Zhang, Runzhou Pan, Rongju Zhang, Yongcai Zhao
INTRODUCTION: Liddle syndrome is an autosomal dominant disorder characterized by hypertension, hypokalemia, low aldosterone levels, and reduced renin activity. Atypical Liddle syndrome can be easily misdiagnosed due to its clinical phenotypes resembling hyperaldosteronism. PATIENT CONCERN: The patient was diagnosed with primary aldosteronism due to hypertension and hypokalemia, and underwent left adrenalectomy. After the operation, the patient still had hypertension and hypokalemia that were not easy to control and correct, and had acute cerebral infarction...
November 24, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/38009955/hyperaldosteronism-screening-and-findings-from-a-large-diverse-population-with-resistant-hypertension-within-an-integrated-health-system
#32
JOURNAL ARTICLE
Victor Kim, Jiaxiao Shi, Jaejin An, Simran Bhandari, Jeffrey W Brettler, Michael H Kanter, John J Sim
INTRODUCTION: Hyperaldosteronism (HA) is a common cause of secondary hypertension and may contribute to resistant hypertension (RH). The authors sought to determine and characterize HA screening, positivity rates, and mineralocorticoid receptor antagonist (MRA) use among patients with RH. METHODS: A cross-sectional study was performed within Kaiser Permanente Southern California (7/1/2012-6/30/2017). Using contemporary criteria, RH was defined as blood pressure uncontrolled (≥ 130/80) on ≥ 3 medications or requiring ≥ 4 antihypertensive medications...
March 15, 2024: Permanente Journal
https://read.qxmd.com/read/37993292/primary-aldosteronism-practical-recommendations-for-treatment-and-follow-up
#33
REVIEW
M Araujo-Castro, E Pascual-Corrales, P Martín Rojas, P Parra Ramírez
Primary aldosteronism (PA) is the most common cause of secondary arterial hypertension. For unilateral cases, surgery offers the possibility of cure, with unilateral adrenalectomy being the treatment of choice, whereas bilateral forms of PA are treated mainly with mineralocorticoid receptor antagonists (MRA). The goals of treatment for PA due to either unilateral or bilateral adrenal disease include reversal of the adverse cardiovascular effects of hyperaldosteronism, normalization of serum potassium in patients with hypokalemia, and normalization of blood pressure...
2023: Hipertensión y Riesgo Vascular
https://read.qxmd.com/read/37964158/diagnosis-and-management-of-primary-hyperaldosteronism-in-patients-with-hypertension-a-practical-approach-endorsed-by-the-british-and-irish-hypertension-society
#34
REVIEW
Luca Faconti, Spoorthy Kulkarni, Christian Delles, Vikas Kapil, Philip Lewis, Mark Glover, Thomas M MacDonald, Ian B Wilkinson
Alongside the lack of homogeneity among international guidelines and consensus documents on primary hyperaldosteronism, the National UK guidelines on hypertension do not provide extensive recommendations regarding the diagnosis and management of this condition. Local guidelines vary from area to area, and this is reflected in the current clinical practice in the UK. In an attempt to provide support to the clinicians involved in the screening of subjects with hypertension and clinical management of suspected cases of primary hyperaldosteronism the following document has been prepared on the behalf of the BIHS Guidelines and Information Service Standing Committee...
November 14, 2023: Journal of Human Hypertension
https://read.qxmd.com/read/37946600/time-to-benefit-of-surgery-vs-targeted-medical-therapy-for-patients-with-primary-aldosteronism-a-meta-analysis
#35
JOURNAL ARTICLE
Sunil Samnani, Irena Cenzer, Gregory A Kline, Sei J Lee, Gregory L Hundemer, Caitlin McClurg, Janice L Pasieka, W John Boscardin, Paul E Ronksley, Alexander A Leung
CONTEXT: Primary aldosteronism (PA) is one of the most common causes of secondary hypertension, but the comparative outcomes of targeted treatment remain unclear. OBJECTIVE: To compare the clinical outcomes in patients treated for primary aldosteronism over time. METHODS: Medline and EMBASE were searched. Original studies reporting the incidence of mortality, major adverse cardiovascular outcomes (MACE), progression to chronic kidney disease, or diabetes following adrenalectomy vs medical therapy were selected...
February 20, 2024: Journal of Clinical Endocrinology and Metabolism
https://read.qxmd.com/read/37909000/dual-aldosterone-and-cortisol-secreting-adrenal-cortical-carcinoma-pre-and-perioperative-evaluation-and-management
#36
Rebecca Rosenberg, Christopher D Raeburn, Michael R Clay, Margaret E Wierman
Adrenal cortical carcinoma (ACC) is a rare cancer (1-2/million) that presents with hormone overproduction in 60% of cases. Presentation of ACC with multiple hormone syndromes from different adrenal zones is rare. We present a case of dual-secreting ACC with hyperaldosteronism and cortisol excess. The previously healthy patient was noted to have new-onset hypertension and hypokalemia during a primary care visit. On hormonal evaluation, he was found to have evidence of hyperaldosteronism and adrenocorticotropic hormone (ACTH)-independent cortisol excess...
July 2023: JCEM Case Rep
https://read.qxmd.com/read/37908267/reduction-of-proteinuria-in-a-patient-with-primary-aldosteronism-by-angiotensin-ii-receptor-blocker-administration
#37
Junjiro Rikitake, Kenji Ashida, Mami Miura, Masatoshi Nomura
The renin-angiotensin-aldosterone system (RAAS) is a major target for treating hypertension and preventing various complications. Mineralocorticoid receptor (MR) antagonists are recommended as specific drugs to ameliorate hyperactive MR signaling, especially for patients with idiopathic hyperaldosteronism. However, the clinical implications of an increased RAAS activity and angiotensin II level induced by MR antagonist administration remain unclear. A 72-year-old Japanese man was referred to our university hospital for refractory hypertension management...
January 2023: JCEM Case Rep
https://read.qxmd.com/read/37908248/pseudo-primary-aldosteronism-as-initial-presentation-of-ectopic-acth-syndrome-in-metastatic-small-cell-lung-cancer
#38
Jonathan Shakesprere, Reima El Naili, Mehjabeen Sadiq, Adnan Haider
Ectopic adrenocorticotropic hormone (ACTH)-secreting syndrome (EAS) is a rare but often aggressive paraneoplastic syndrome. Patients with EAS typically present with high ACTH levels and rapid clinical progression in the setting of acute cortisol elevation, which can delay diagnosis due to a lack of typical Cushingoid features. High levels of ACTH have also been shown to stimulate the adrenal zona glomerulosa to oversecrete aldosterone. We present the case of a 58-year-old male individual presenting with new-onset hypertension and severe metabolic alkalosis with spontaneous hypokalemia, in the setting of elevated aldosterone and low renin levels, suggestive of primary aldosteronism...
January 2023: JCEM Case Rep
https://read.qxmd.com/read/37883217/evaluating-phase-ii-results-of-baxdrostat-an-aldosterone-synthase-inhibitor-for-hypertension
#39
REVIEW
Ayoola Awosika, Yoonje Cho, Ujjal Bose, Adekunle E Omole, Uzochukwu Adabanya
INTRODUCTION: Hypertension, a global health concern, poses a significant risk for other cardiovascular diseases. While lifestyle modifications and interventions like the Dietary Approaches to Stop Hypertension (DASH) diet offer some respite, their maintenance can be challenging. Recently, the spotlight has turned toward the renin-angiotensin-aldosterone system, a crucial player in the pathophysiology of hypertension. Contrary to other drugs, Baxdrostat, an innovative aldosterone synthase inhibitor (ASI), targets aldosterone synthesis, mitigating negative systemic effects...
October 26, 2023: Expert Opinion on Investigational Drugs
https://read.qxmd.com/read/37877173/redefining-primary-hyperaldosteronism-as-the-syndrome-of-inappropriate-aldosterone-secretion-sialds-a-common-but-unrecognized-cause-of-hypertension
#40
REVIEW
Rajat Lamba
The current screening and diagnostic recommendations for detecting Primary Hyperaldosteronism (PHA) focus on diagnosing the more severe and overt instances of renin-independent aldosterone production. However, milder forms of autonomous aldosterone secretion have been demonstrated to exist below the diagnostic thresholds of current PHA guidelines, and associate with clinically relevant cardiovascular risk. PHAencompasses a spectrum of renin independent aldosterone production, progressing from a subclinical state in normotensives to a full-blown clinical syndrome representing the resistant hypertension population...
December 2023: Journal of Clinical Hypertension
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