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hyperaldosteronism primary

Nora Franceschini, Cara L Carty, Yingchang Lu, Ran Tao, Yun Ju Sung, Ani Manichaikul, Jeff Haessler, Myriam Fornage, Karen Schwander, Niha Zubair, Stephanie Bien, Lucia A Hindorff, Xiuqing Guo, Suzette J Bielinski, Georg Ehret, Joel D Kaufman, Stephen S Rich, Christopher S Carlson, Erwin P Bottinger, Kari E North, D C Rao, Aravinda Chakravarti, Paula Q Barrett, Ruth J F Loos, Steven Buyske, Charles Kooperberg
Despite the substantial burden of hypertension in US minority populations, few genetic studies of blood pressure have been conducted in Hispanics and African Americans, and it is unclear whether many of the established loci identified in European-descent populations contribute to blood pressure variation in non-European descent populations. Using the Metabochip array, we sought to characterize the genetic architecture of previously identified blood pressure loci, and identify novel cardiometabolic variants related to systolic and diastolic blood pressure in a multi-ethnic US population including Hispanics (n = 19,706) and African Americans (n = 18,744)...
2016: PloS One
Georgios Daniil, Fabio L Fernandes-Rosa, Jean Chemin, Iulia Blesneac, Jacques Beltrand, Michel Polak, Xavier Jeunemaitre, Sheerazed Boulkroun, Laurence Amar, Tim M Strom, Philippe Lory, Maria-Christina Zennaro
Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenoma (APA) and familial hyperaldosteronism (FH). A recurrent mutation in CACNA1H (coding for Cav3.2) was identified in a familial form of early onset PA. Here we performed whole exome sequencing (WES) in patients with different types of PA to identify new susceptibility genes. Four different heterozygous germline CACNA1H variants were identified. A de novo Cav3...
October 4, 2016: EBioMedicine
Ayako Moriya, Masaaki Yamamoto, Shunsuke Kobayashi, Tomoko Nagamine, Naomi Takeichi-Hattori, Mototsugu Nagao, Taro Harada, Kyoko Tanimura-Inagaki, Shiro Onozawa, Satoru Murata, Hideki Tamura, Izumi Fukuda, Shinichi Oikawa, Hitoshi Sugihara
The diagnostic steps for primary aldosteronism (PA) include case screening tests, confirmatory tests, and localization. The aim of this study was to identify useful confirmatory tests and their cut-off values for differentiating the subtype of primary aldosteronism, especially in unilateral PA, such as aldosterone-producing adenoma, and bilateral PA, such as idiopathic hyperaldosteronism. Seventy-six patients who underwent all four confirmatory tests, the captopril-challenge test (CCT), furosemide upright test (FUT), saline infusion test (SIT), and ACTH stimulation test (AST), and who were confirmed to have an aldosterone excess by adrenal venous sampling (AVS) were recruited...
October 1, 2016: Endocrine Journal
Giuseppe Maiolino, Alberto Flego, Gian Paolo Rossi
OBJECTIVE: PA causes excess cardiovascular (CV) damage, but whether it worsens prognosis remained uncertain as there are no prospective studies. To compare long-term outcome of the 1125 patients recruited in the PAPY study. DESIGN AND METHOD: 11.2% of the PAPY study patients had PA: 6.4% idiopathic hyperaldosteronism (IHA) received medical therapy; 4,8% aldosterone-producing adenoma (APA) required adrenalectomy. Endpoints were total and CV mortality, major adverse cardiovascular events (MACE) and total CV events...
September 2016: Journal of Hypertension
David Calhoun
: Resistant hypertension refers to patients with difficult-to-treat hypertension, generally defined as needing three or more medications of different classes, including, if tolerated, a diuretic. Observational studies indicate that the prevalence of resistant hypertension based on the preceding definition of needing 3 or medications for blood pressure (BP) control is approximately 15-20% of patients being treated for hypertension. However, causes of pseudoresistance are common, including poor BP technique, poor adherence, white coat effects, and under-treatment, all of which must be identified in order to distinguish apparent resistance from true treatment resistance...
September 2016: Journal of Hypertension
Sang-Chol Lee
Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension...
September 2016: Journal of Hypertension
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
Tanja Dudenbostel, David A Calhoun
BACKGROUND: Multiple studies indicate that primary aldosteronism (PA) is common in patients with resistant hypertension, with an estimated prevalence of approximately 20%. Additional studies suggest that beyond this 20% of patients with classical PA, there is a larger proportion of patients with lesser degrees of hyperaldosteronism which contributes even more broadly to antihypertensive treatment resistance. Given these observations, it is intuitive that use of aldosterone antagonists will provide antihypertensive benefit in patients with resistant hypertension and evidence of aldosterone excess...
September 8, 2016: American Journal of Hypertension
F Satoh, Y Ono, R Morimoto, Y Iwakura, M Nezu, K Omata, Y Tezuka, Y Igarashi, M Kudo, S Ito
OBJECTIVE: The measurement of plasma aldosterone concentration (PAC) and renin activity (PRA) or active renin concentration (ARC) is clinically important not only for detection of primary aldosteronism but also for the selection of antihypertensive agents to treat patients successfully. However, it has taken approximately 7 days for clinicians to get the results. Of late, we developed the novel rapid non-RIA assays of PAC and ARC, which are measurable in 10 minutes. This study is intended to investigate the utility and accuracy of this new methods...
September 2016: Journal of Hypertension
G Daniil, F L Fernandes-Rosa, J Chemin, X Jeunemaitre, M Polak, S Boulkroun, L Amar, T M Strom, P Lory, M C Zennaro
OBJECTIVE: Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenomas (APA) and familial hyperaldosteronism (FH). Recently, a recurrent germline mutation in CACNA1H (encoding the T-type voltage-dependent calcium channel Cav3.2) was identified in a new familial form of early onset hypertension and PA. DESIGN AND METHOD: To identify new genes responsible for PA, we have performed whole exome sequencing in 23 patients with APA, 10 patients with FH and in two trios with the proband presenting early onset PA...
September 2016: Journal of Hypertension
A Kaszuba, A Konior, T Mikolajczyk, A Prejbisz, M Kabat, I Cendrowska-Demkow, P Dobrowolski, B Pregowska-Chwala, K Michel-Rowicka, A Klisiewicz, P Michalek, S Toutounchi, Z Galazka, M Reincke, A Januszewicz, Tj Guzik
OBJECTIVE: Role of the T cells in pathogenesis of hypertension has been demonstrated in numerous mouse models, limited data is available in human hypertension. Therefore the aim of our study was to quantify blood T lymphocyte subsets, characterized by expression of CD25 markers (CD3 + , CD8 + and CD3 + CD4-CD8- cells) and expression of perforin and granzyme (in CD8 + cells) in subjects with primary hyperaldosteronism (PA), resistant hypertension (RHT) characterized by increased cardiovascular risk and excessive amounts of circulating aldosterone in comparison to controls matched for age, sex and BMI(control group, CG)...
September 2016: Journal of Hypertension
Ravi Kumar Dutta, Peter Söderkvist, Oliver Gimm
Hypertension is a common medical condition and affects approximately 20% of the population in developed countries. Primary aldosteronism is the most common form of secondary hypertension and affects 8-13% of patients with hypertension. The two most common causes of primary aldosteronism are aldosterone-producing adenoma and bilateral adrenal hyperplasia. Familial hyperaldosteronism types I, II and III are the known genetic syndromes, in which both adrenal glands produce excessive amounts of aldosterone. However, only a minority of patients with primary aldosteronism have one of these syndromes...
October 2016: Endocrine-related Cancer
Felicia Leccia, Marie Batisse-Lignier, Isabelle Sahut-Barnola, Pierre Val, A-Marie Lefrançois-Martinez, Antoine Martinez
Adrenal cortex tumors are divided into benign forms, such as primary hyperplasias and adrenocortical adenomas (ACAs), and malignant forms or adrenocortical carcinomas (ACCs). Primary hyperplasias are rare causes of adrenocorticotropin hormone-independent hypercortisolism. ACAs are the most common type of adrenal gland tumors and they are rarely "functional," i.e., producing steroids. When functional, adenomas result in endocrine disorders, such as Cushing's syndrome (hypercortisolism) or Conn's syndrome (hyperaldosteronism)...
2016: Frontiers in Endocrinology
Silvia Lai, Luigi Petramala, Daniela Mastroluca, Emanuela Petraglia, Alessandro Di Gaeta, Elena Indino, Valeria Panebianco, Mauro Ciccariello, Hossein H Shahabadi, Alessandro Galani, Claudio Letizia, Anna Rita D'Angelo
Hypertension is commonly associated with autosomal dominant polycystic kidney disease (ADPKD), often discovered before the onset of renal failure, albeit the pathogenetic mechanisms are not well elucidated. Hyperaldosteronism in ADPKD may contribute to the development of insulin resistance and endothelial dysfunction, and progression of cardiorenal disease. The aim of study was to evaluate the prevalence of primary aldosteronism (PA) in ADPKD patients and identify some surrogate biomarkers of cardiovascular risk...
July 2016: Medicine (Baltimore)
Tingting Yang, Hai-Liang Zhang, Qingnan Liang, Yingtang Shi, Yan-Ai Mei, Paula Q Barrett, Changlong Hu
Aldosterone, which plays a key role in maintaining water and electrolyte balance, is produced by zona glomerulosa cells of the adrenal cortex. Autonomous overproduction of aldosterone from zona glomerulosa cells causes primary hyperaldosteronism. Recent clinical studies have highlighted the pathological role of the KCNJ5 potassium channel in primary hyperaldosteronism. Our objective was to determine whether small-conductance Ca(2+)-activated potassium (SK) channels may also regulate aldosterone secretion in human adrenocortical cells...
September 2016: Hypertension
Sujit Vakkalanka, Andrew Zhao, Mohammed Samannodi
Primary hyperaldosteronism is one of the most common causes of secondary hypertension but clear differentiation between its various subtypes can be a clinical challenge. We report the case of a 37-year-old African-American woman with refractory hypertension who was admitted to our hospital for palpitations, shortness of breath and headache. Her laboratory results showed hypokalaemia and an elevated aldosterone/renin ratio. An abdominal CT scan showed a nodule in the left adrenal gland but adrenal venous sampling showed elevated aldosterone/renin ratio from the right adrenal vein...
2016: BMJ Case Reports
Anli Tong, Guanghua Liu, Fen Wang, Jun Jiang, Zhaoli Yan, Dianxi Zhang, Yinsheng Zhang, Jun Cai
CONTEXT: To date, all the familial hyperaldosteronism type III (FH-III) patients reported presented with typical primary aldosteronism (PA), without showing other adrenal hormone abnormalities. OBJECTIVE: This study characterized a novel phenotype of FH-III, and explored the possible pathogenesis. PATIENTS AND METHODS: A male patient presented with severe hypertension and hypokalemia at the age of 2, and developed Cushing's syndrome at 20...
July 12, 2016: Journal of Clinical Endocrinology and Metabolism
Elon H C van Dijk, Michiel F Nijhoff, Eiko K de Jong, Onno C Meijer, Aiko P J de Vries, Camiel J F Boon
PURPOSE: To describe ophthalmological characteristics of 13 patients with primary hyperaldosteronism (PA). METHODS: Cross-sectional study. All patients underwent extensive ophthalmological examination. RESULTS: Thirteen PA patients (9 male, 4 female) were diagnosed with arterial hypertension for 11.0 ± 11.2 years. Ophthalmological imaging revealed macular serous subretinal fluid (SRF) on optical coherence tomography in 2 patients (15 %)...
July 8, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Andrea Michelli, Stella Bernardi, Andrea Grillo, Emiliano Panizon, Matteo Rovina, Moreno Bardelli, Renzo Carretta, Bruno Fabris
BACKGROUND: Malignant hypertension is a condition characterized by severe hypertension and multi-organ ischemic complications. Albeit mortality and renal survival have improved with antihypertensive therapy, progression to end-stage renal disease remains a significant cause of morbidity and mortality. The underlying cause of malignant hypertension, which can be primary or secondary hypertension, is often difficult to identify and this can substantially affect the treatment outcomes, as we report here...
2016: BMC Nephrology
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