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Primary aldosteronism with normal aldosterone

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https://www.readbyqxmd.com/read/28202622/the-hypertension-pandemic-an-evolutionary-perspective
#1
REVIEW
Bernard C Rossier, Murielle Bochud, Olivier Devuyst
Hypertension affects over 1.2 billion individuals worldwide and has become the most critical and expensive public health problem. Hypertension is a multifactorial disease involving environmental and genetic factors together with risk-conferring behaviors. The cause of the disease is identified in ∼10% of the cases (secondary hypertension), but in 90% of the cases no etiology is found (primary or essential hypertension). For this reason, a better understanding of the mechanisms controlling blood pressure in normal and hypertensive patients is the aim of very active experimental and clinical research...
March 2017: Physiology
https://www.readbyqxmd.com/read/28129245/plasma-aldosterone-level-within-the-normal-range-is-less-associated-with-cardiovascular-and-cerebrovascular-risk-in-primary-aldosteronism
#2
Masahiko Murata, Tetsuhiro Kitamura, Daisuke Tamada, Kosuke Mukai, Shogo Kurebayashi, Tsunehiko Yamamoto, Kunihiko Hashimoto, Reiko D Hayashi, Haruhiko Kouhara, Sachi Takeiri, Yoshitaka Kajimoto, Makoto Nakao, Toshimitsu Hamasaki, Michio Otsuki, Iichiro Shimomura
BACKGROUND: Previous studies showed higher risk of cardiovascular and cerebrovascular (CCV) events in primary aldosteronism compared with essential hypertension, but the patients of these studies were limited to primary aldosteronism patients with high plasma aldosterone concentration (PAC). The introduction of the aldosterone-renin ratio as the screening test for primary aldosteronism led to the recognition of primary aldosteronism patients with normal PAC (nPA). However, there is no information on the risk of primary aldosteronism including nPA...
January 27, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28101185/hypokalemic-myopathy-in-primary-aldosteronism-a-case-report
#3
Chuifen Wu, Jun Xin, Minghua Xin, Hai Zou, Lie Jing, Caoyong Zhu, Wenhui Lei
Primary aldosteronism (PA) is a rare disorder. The majority of patients with PA present with typical features and are easily diagnosed. This disorder is usually diagnosed with hypokalemia, hypertension or an adrenal mass. However, patients with atypical symptoms may present a challenge for diagnosis and treatment. In the present study, a case of PA is described that presented with hypokalemic myopathy simulating polymyositis. The patient was a 44-year-old woman who presented with weakness and difficulty walking...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28074381/adrenal-hormones-before-and-after-venography-during-adrenal-venous-sampling-a-self-controlled-study
#4
Yuya Koike, Seishi Matsui, Masao Omura, Kohzoh Makita, Alfonso W D Obara, Nobukazu Moriya, Tetsuo Nishikawa
OBJECTIVE: A stress reaction involving increased adrenal hormone release occurs when starting adrenal venous sampling (AVS). The purpose of the present study was to investigate the effect of single shot venography on adrenal hormone production during AVS. SUBJECTS AND METHODS: This was a prospective self-controlled study. We enrolled 54 consecutive patients (21 men, 33 women; mean age 52 ± 11 years) with primary aldosteronism who underwent AVS from May 2014 to February 2015...
January 10, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27965370/genetic-characterization-of-a-mouse-line-with-primary-aldosteronism
#5
Luis Gustavo Perez-Rivas, Yara Rhayem, Sibylle Sabrautzki, Constanze Hantel, Birgit Rathkolb, Martin Hrabé de Angelis, Martin Reincke, Felix Beuschlein, Ariadni Spyroglou
In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism a mutagenesis screen following treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. The steroidogenic enzyme expression levels in the adrenal gland did not differ significantly among phenotypically affected and unaffected mice...
December 13, 2016: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/27957422/unmasked-chronic-renal-function-deterioration-after-unilateral-adrenalectomy-in-patients-with-primary-aldosteronism
#6
Su Min Park, Woo Jin Jung, Jong Man Park, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Nari Shin, Sang Heon Song
We report 2 cases of chronic estimated glomerular filtration rate (eGFR) decline after unilateral adrenalectomy due to primary aldosteronism. The patients were diagnosed with unilateral adrenal cortical adenoma releasing aldosterone. Two patients were examined for hypertension and hypokalemia. Unilateral laparoscopic adrenalectomy was performed in both cases, and pathology confirmed adrenal cortical adenoma. After adrenalectomy, hypertension and hypokalemia improved to within normal range. However, the eGFR decreased postoperatively, and abdominal computed tomography scan showed decreased kidney size compared to previous images...
December 2016: Kidney Research and Clinical Practice
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
#7
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
#8
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
#9
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
#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/27748964/volumetric-and-densitometric-evaluation-of-the-adrenal-glands-in-patients-with-primary-aldosteronism
#11
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 with normal controls. DESIGN: A total of 77 patients (56 males and 21 females) diagnosed with primary aldosteronism (PA) with a mean age of 53 ± 10 years were prospectively enrolled. Unenhanced and contrast-enhanced computed tomography scans were analysed for adrenal volumes and mean densities. These values were compared with normal controls and between PA subtypes...
March 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/27678389/volume-regulatory-hormones-and-plasma-volume-in-pregnant-women-with-sickle-cell-disorder
#12
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
#13
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
#14
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
#15
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
#16
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
#17
REVIEW
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...
February 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/27592061/-hypertension-etiological-work-up-hormonological-assessment-always-before-imaging
#18
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...
October 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27589343/the-clinical-value-of-salivary-aldosterone-in-diagnosis-and-follow-up-of-primary-aldosteronism
#19
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
#20
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
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