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Primary aldosteronism with normal aldosterone

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https://www.readbyqxmd.com/read/27836073/changes-in-the-renin-angiotensin-aldosterone-system-in-response-to-dietary-salt-intake-in-normal-and-hypertensive-pregnancy-a-randomized-trial
#1
Lise H Nielsen, Per Ovesen, Mie R Hansen, Steven Brantlov, Bente Jespersen, Peter Bie, Boye L Jensen
It was hypothesized that primary renal sodium retention blunted the reactivity of the renin-angiotensin-aldosterone system to changes in salt intake in preeclampsia (PE). A randomized, cross-over, double-blinded, dietary intervention design was used to measure the effects of salt tablets or placebo during low-salt diet in PE patients (n = 7), healthy pregnant women (n = 15), and nonpregnant women (n = 13). High-salt intake decreased renin and angiotensin II concentrations significantly in healthy pregnant women (P < ...
November 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27754198/js-ish-eccr-3-a-novel-algorithm-for-the-case-detection-of-the-most-common-form-of-endocrine-hypertension
#2
Gian Paolo Rossi
Primary aldosteronism (PA) involves more than 11% of patients referred to specialized hypertension centers and, therefore, is much more common than commonly held. Moreover, it causes a damage to the heart, blood vessels and kidneys, which translates into a high rate of cardiovascular events, in excess to the degree of blood pressure raise. Along with the notion that a timely diagnosis entails a fundamental step for the choice of an appropriate therapy, which can correct the arterial hypertension and the hypokalemia, this justifies efforts to search for PA in the majority of the patients with hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753896/os-01-05-high-aldosterone-renin-ratio-arr-is-associated-with-the-development-of-essential-hypertension-from-white-coat-hypertension
#3
Ami Kwon, Woo-Baek Chung, Tae-Hoon Kim, Suk Min Suh, Eun Ho Chu, Sung-Won Jang, GeeHee Kim, Sang Hyun Ihm
OBJECTIVE: There are many reports about white coat hypertension (WCH), still the clinical significance and pathophysiology of WCH is ambiguous. The aim of this study was to find out the difference of RAAS activity in WCH compared with the essential hypertension (EH) group, which could suggest the role of RAAS activity in the development of WCH. DESIGN AND METHOD: Never treated hypertension patients who visited 8 hospitals of The Catholic University of Korea from January 2011 through July 2012 were enrolled...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753830/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#4
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
https://www.readbyqxmd.com/read/27748964/volumetric-and-densitometric-evaluation-of-the-adrenal-glands-in-patients-with-primary-aldosteronism
#5
Christoph Degenhart, Julia Schneller, Andrea Osswald, Anna Pallauf, Anna Riester, Maximilian F Reiser, Martin Reincke, Felix Beuschlein
OBJECTIVE: To evaluate volumetric and densitometric properties of the adrenal glands in patients with unilateral and bilateral disease in comparison to normal controls. DESIGN: 77 patients (56 male and 21 female) diagnosed with primary aldosteronism (PA) with a mean age of 53±10 years were prospectively enrolled. Unenhanced and contrast enhanced CT scans were analyzed for adrenal volumes and mean densities. f These values were compared with normal controls and between PA subtypes...
October 17, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27678389/volume-regulatory-hormones-and-plasma-volume-in-pregnant-women-with-sickle-cell-disorder
#6
Bosede B Afolabi, Olajumoke O Oladipo, Alani S Akanmu, Olalekan O Abudu, Olusoga A Sofola, Fiona Broughton Pipkin
BACKGROUND: Sickle cell disease (haemoglobin SS (HbSS)) mainly affects those of West African origin and is associated with hypervolaemia. Plasma volume rises by up to 50% in normal pregnancy but was previously found to be paradoxically contracted in late sickle cell pregnancy. The renin-angiotensin-aldosterone system is activated very early in human pregnancy to support the plasma volume expansion. We hypothesised that activation of the renin-angiotensin-aldosterone system would be blunted in pregnant women with sickle cell disease...
July 2016: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/27648962/aldosterone-producing-adenoma-with-a-somatic-kcnj5-mutation-revealing-apc-dependent-familial-adenomatous-polyposis
#7
Julien Vouillarmet, Fabio Fernandes-Rosa, Julia Graeppi-Dulac, Pierre Lantelme, Myriam Decaussin-Petrucci, Charles Thivolet, Jean-Louis Peix, Sheerazed Boulkroun, Eric Clauser, Maria-Christina Zennaro
CONTEXT: Recurrent somatic mutations in KCNJ5, CACNA1D, ATP1A1 and ATP2B3 have been identified in aldosterone producing adenomas (APA). The question as to whether they are responsible for both nodulation and aldosterone production is not solved. CASE DESCRIPTION: We describe the case of a young patient who was diagnosed with severe arterial hypertension due to primary aldosteronism at age 26, followed by hemorrhagic stroke four years later. Abdominal computed tomography showed bilateral macronodular adrenal hyperplasia...
September 20, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27643242/os-01-05-high-aldosterone-renin-ratio-arr-is-associated-with-the-development-of-essential-hypertension-from-white-coat-hypertension
#8
Ami Kwon, Woo-Baek Chung, Tae-Hoon Kim, Suk Min Suh, Eun Ho Chu, Sung-Won Jang, GeeHee Kim, Sang Hyun Ihm
OBJECTIVE: There are many reports about white coat hypertension (WCH), still the clinical significance and pathophysiology of WCH is ambiguous. The aim of this study was to find out the difference of RAAS activity in WCH compared with the essential hypertension (EH) group, which could suggest the role of RAAS activity in the development of WCH. DESIGN AND METHOD: Never treated hypertension patients who visited 8 hospitals of The Catholic University of Korea from January 2011 through July 2012 were enrolled...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643155/js-ish-eccr-3-a-novel-algorithm-for-the-case-detection-of-the-most-common-form-of-endocrine-hypertension
#9
Gian Paolo Rossi
Primary aldosteronism (PA) involves more than 11% of patients referred to specialized hypertension centers and, therefore, is much more common than commonly held. Moreover, it causes a damage to the heart, blood vessels and kidneys, which translates into a high rate of cardiovascular events, in excess to the degree of blood pressure raise. Along with the notion that a timely diagnosis entails a fundamental step for the choice of an appropriate therapy, which can correct the arterial hypertension and the hypokalemia, this justifies efforts to search for PA in the majority of the patients with hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642883/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#10
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
https://www.readbyqxmd.com/read/27609503/use-of-aldosterone-antagonists-for-treatment-of-uncontrolled-resistant-hypertension
#11
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
https://www.readbyqxmd.com/read/27592061/-hypertension-etiological-work-up-hormonological-assessment-always-before-imaging
#12
Bernard Chamontin, Florent Seguro, Nicolas Touront, Béatrice Bouhanick
The purpose is to consider the practical management of etiological work up in hypertension, beyond national or international recommendations, leading to consider the prior practice of hormonal assays or renal, renovascular or adrenal imaging. The ease of access to imaging, difficulties to meet the requirements to obtain reliable hormonal assays explain the use of first-line imaging in clinical practice. The renal and adrenal CT angiography provides diagnostic orientation without allowing a formal conclusion...
August 31, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27589343/the-clinical-value-of-salivary-aldosterone-in-diagnosis-and-follow-up-of-primary-aldosteronism
#13
U D Lichtenauer, S Gerum, E Asbach, J Manolopoulou, V Fourkiotis, M Quinkler, M Bidlingmaier, M Reincke
Primary aldosteronism (PA), the most common form of secondary hypertension, causes relevant morbidity. The value of salivary measurements of aldosterone in clinical routine in PA so far has not been assessed. First, we analyzed salivary and plasma aldosterone concentrations of 42 patients with PA and 37 hypertensive controls (HC) during a sodium infusion test prospectively. Second, morning salivary and plasma aldosterone concentrations as well as diurnal saliva aldosterone profiles were analyzed in 115 patients treated for PA (46 adrenalectomy, 56 spironolactone, 13 eplerenone)...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27514282/somatic-kcnj5-mutation-occurring-early-in-adrenal-development-may-cause-a-novel-form-of-juvenile-primary-aldosteronism
#14
Ai Tamura, Koshiro Nishimoto, Tsugio Seki, Yoko Matsuzawa, Jun Saito, Masao Omura, Celso E Gomez-Sanchez, Kohzoh Makita, Seishi Matsui, Nobukazu Moriya, Atsushi Inoue, Maki Nagata, Hironobu Sasano, Yasuhiro Nakamura, Yuto Yamazaki, Yasuaki Kabe, Kuniaki Mukai, Takeo Kosaka, Mototsugu Oya, Sachiko Suematsu, Tetsuo Nishikawa
We report a case of non-familial juvenile primary aldosteronism (PA). Super-selective adrenal venous sampling identified less aldosterone production in the right inferior adrenal segment than others. Bilateral adrenalectomy sparing the segment normalized blood pressure and improved PA. Both adrenals had similar histologies, consisting of a normal adrenal cortex and aldosterone synthase-positive hyperplasia/adenoma. An aldosterone-driving KCNJ5 mutation was detected in the lesions, but not in the histologically normal cortex...
August 8, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27511444/radiofrequency-ablation-compared-with-laparoscopic-adrenalectomy-for-aldosterone-producing-adenoma
#15
S Y Liu, C M Chu, A P Kong, S K Wong, P W Chiu, F C Chow, E K Ng
BACKGROUND: Radiofrequency ablation (RFA) is an emerging treatment for primary aldosteronism owing to aldosterone-producing adenoma. Whether RFA could be an alternative treatment to laparoscopic adrenalectomy is unknown. METHODS: This was a retrospective comparative study in patients with aldosterone-producing adenoma undergoing either laparoscopic adrenalectomy or CT-guided percutaneous RFA between 2004 and 2012. Short-term outcomes and long-term resolution rates of primary aldosteronism (normalized aldosterone to renin ratio), hypokalaemia and hypertension (BP lower than 140/90 mmHg without antihypertensive medical therapy) were evaluated...
October 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27508698/-op-4b-03-circulating-aldosterone-levels-are-associated-with-concentric-left-ventricular-geometry-in-essential-hypertensive-patients
#16
G Mule', E Nardi, L Guarino, M Morreale, D Altieri, G Geraci, M Guarneri, V Cacciatore, G Cerasola, S Cottone
OBJECTIVE: Sound evidence indicates that aldosterone has a fundamental role in determining functional and structural changes in the heart. Moreover, it has been observed that high plasma aldosterone concentration (PAC) is related to the development of congestive heart failure and to cardiovascular mortality. However, previous studies on the association between circulating aldosterone levels and left ventricular (LV) mass (LVM) and LV geometry, in subjects without primary aldosteronism yielded conflicting results...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27460219/severe-hyperkalemia-following-adrenalectomy-for-aldosteronoma-prediction-pathogenesis-and-approach-to-clinical-management-a-case-series
#17
A Tahir, K McLaughlin, G Kline
BACKGROUND: As the field of Primary Aldosteronism (PA) becomes ever expanded, diagnosis of PA is increasingly diagnosed by endocrinologists. With increased PA screening, many of the cases are now found in patients with complex co-morbidities in addition to their hypertension. Post adrenalectomy renal impairment with hyperkalemia is now increasingly seen in these complex patients, as evidenced by the numerous reports on this issue that have appeared within the past 3 years. We present a small case series to illustrate the breadth of the problem, along with a discussion about how such CKD/hyperkalemic events may be predicted...
July 27, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27445975/role-of-acth-and-other-hormones-in-the-regulation-of-aldosterone-production-in-primary-aldosteronism
#18
REVIEW
Nada El Ghorayeb, Isabelle Bourdeau, André Lacroix
The major physiological regulators of aldosterone production from the adrenal zona glomerulosa are potassium and angiotensin II; other acute regulators include adrenocorticotropic hormone (ACTH) and serotonin. Their interactions with G-protein coupled hormone receptors activate cAMP/PKA pathway thereby regulating intracellular calcium flux and CYP11B2 transcription, which is the specific steroidogenic enzyme of aldosterone synthesis. In primary aldosteronism (PA), the increased production of aldosterone and resultant relative hypervolemia inhibits the renin and angiotensin system; aldosterone secretion is mostly independent from the suppressed renin-angiotensin system, but is not autonomous, as it is regulated by a diversity of other ligands of various eutopic or ectopic receptors, in addition to activation of calcium flux resulting from mutations of various ion channels...
2016: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/27442639/hyperaldosteronism-and-cardiovascular-risk-in-patients-with-autosomal-dominant-polycystic-kidney-disease
#19
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)
https://www.readbyqxmd.com/read/27430645/disorganized-steroidogenesis-in-adrenocortical-carcinoma-a-case-study
#20
Toyoyoshi Uchida, Koshiro Nishimoto, Yuki Fukumura, Miki Asahina, Hiromasa Goto, Yui Kawano, Fumitaka Shimizu, Akira Tsujimura, Tsugio Seki, Kuniaki Mukai, Yasuaki Kabe, Makoto Suematsu, Celso E Gomez-Sanchez, Takashi Yao, Shigeo Horie, Hirotaka Watada
Most adrenocortical carcinomas (ACCs) produce excessive amounts of steroid hormones including aldosterone, cortisol, and steroid precursors. However, aldosterone- and cortisol-producing cells in ACCs have not yet been immunohistochemically described. We present a case of ACC causing mild primary aldosteronism and subclinical Cushing's syndrome. Removal of the tumor cured both conditions. In order to examine the expression patterns of the steroidogenic enzymes responsible for adrenocortical hormone production, 10 tumor portions were immunohistochemically analyzed for aldosterone synthase (CYP11B2), 11β-hydroxylase (CYP11B1, cortisol-synthesizing enzyme), 3β-hydroxysteroid dehydrogenase (3βHSD, upstream enzyme for both CYP11B2 and CYP11B1), and 17α-hydroxylase/C17-20 lyase (CYP17, upstream enzyme for CYP11B1, but not for CYP11B1)...
July 18, 2016: Endocrine Pathology
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