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Primary aldosterone

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https://www.readbyqxmd.com/read/28708774/identifying-unilateral-disease-in-chinese-patients-with-primary-aldosteronism-by-using-a-modified-prediction-score
#1
Ying Zhang, Wenquan Niu, Fangfang Zheng, Hua Zhang, Wenlong Zhou, Zhoujun Shen, Jianzhong Xu, Xiaofeng Tang, Jin Zhang, Ping-Jin Gao, Ji-Guang Wang, Limin Zhu
OBJECTIVE: The current study aimed to evaluate the role of Küpers' score in predicting unilateral aldosteronism, and develop a modified score in Chinese patients with primary aldosteronism. METHODS: The current retrospective study included 406 patients with primary aldosteronism who underwent successful adrenal venous sampling (AVS) and were divided into the unilateral (n = 211) and bilateral (n = 195) groups according to the AVS results. Normokalemia was noted in both the unilateral (n = 64) and bilateral groups (n = 84) when plasma and urinary aldosterone were measured...
July 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28702747/management-of-supine-hypertension-complicating-neurogenic-orthostatic-hypotension
#2
Jacquie Baker, Kurt Kimpinski
Neurogenic orthostatic hypotension (NOH) can be present in a number of disorders, including synucleinopathies, autoimmune disorders, and various genetic disorders. All are characterized by defective norepinephrine release from sympathetic terminals upon standing, resulting in impaired vasoconstriction. NOH is defined as a drop in systolic blood pressure ≥20 mmHg or diastolic blood pressure ≥10 mmHg, or both, within 3 minutes of standing or head up-tilt at a minimum of 60°. However, approximately 50% of patients have associated supine hypertension, which greatly complicates treatment...
July 12, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28699986/diagnosis-and-management-of-primary-aldosteronism
#3
Leticia A P Vilela, Madson Q Almeida
Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia...
May 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28691036/detection-of-secondary-causes-and-coexisting-diseases-in-hypertensive-patients-osa-and-pa-are-the-common-causes-associated-with-hypertension
#4
Lei Wang, Nanfang Li, Xiaoguang Yao, Guijuan Chang, Delian Zhang, Mulalibieke Heizhati, Menghui Wang, Qin Luo, Jianqiong Kong
BACKGROUND: Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. METHODS: Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. RESULTS: Detection rate of secondary causes and coexisting diseases of hypertension was 39...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28688648/nationwide-review-of-hormonally-active-adrenal-tumors-highlights-high-morbidity-in-pheochromocytoma
#5
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
BACKGROUND: Adrenal adenomas are benign tumors often discovered incidentally, and >70% are hormonally inactive. The remaining subset may produce excess aldosterone, cortisol, or catecholamine. Perioperative outcomes after adrenalectomy for such "hormonally active" tumors remain unclear. This study examines in-hospital outcomes after unilateral adrenalectomy for hormonally active tumors. METHODS: A retrospective review was performed using the Nationwide Inpatient Sample (2006-2011) to identify patients undergoing unilateral adrenalectomy for hormonally active or inactive tumors...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28680564/kidney-dysfunction-in-patients-with-pulmonary-arterial-hypertension
#6
REVIEW
N P Nickel, J M O'Leary, E L Brittain, J P Fessel, R T Zamanian, J D West, E D Austin
Pulmonary arterial hypertension (PH) and chronic kidney disease (CKD) both profoundly impact patient outcomes, whether as primary disease states or as co-morbid conditions. PH is a common co-morbidity in CKD and vice versa. A growing body of literature describes the epidemiology of PH secondary to chronic kidney disease and end-stage renal disease (ESRD) (WHO group 5 PH). But, there are only limited data on the epidemiology of kidney disease in group 1 PH (pulmonary arterial hypertension [PAH]). The purpose of this review is to summarize the current data on epidemiology and discuss potential disease mechanisms and management implications of kidney dysfunction in PAH...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28677050/comparison-of-c-arm-computed-tomography-and-on-site-quick-cortisol-assay-for-adrenal-venous-sampling-a-retrospective-study-of-178-patients
#7
Chin-Chen Chang, Bo-Ching Lee, Yeun-Chung Chang, Vin-Cent Wu, Kuo-How Huang, Kao-Lang Liu
OBJECTIVES: To compare the performance of on-site quick cortisol assay (QCA) and C-arm computed tomography (CT) assistance on adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. METHODS: The institutional review board at our hospital approved this retrospective study, which included 178 consecutive patients with primary aldosteronism. During AVS, we used C-arm CT to confirm right adrenal cannulation between May 2012 and June 2015 (n = 100) and QCA for bilateral adrenal cannulation between July 2015 and September 2016 (n = 78)...
July 4, 2017: European Radiology
https://www.readbyqxmd.com/read/28673579/the-chloride-theory-a-unifying-hypothesis-for-renal-handling-and-body-fluid-distribution-in-heart-failure-pathophysiology
#8
Hajime Kataoka
Body fluid volume regulation is a complex process involving the interaction of various afferent (sensory) and neurohumoral efferent (effector) mechanisms. Historically, most studies focused on the body fluid dynamics in heart failure (HF) status through control of the balance of sodium, potassium, and water in the body, and maintaining arterial circulatory integrity is central to a unifying hypothesis of body fluid regulation in HF pathophysiology. The pathophysiologic background of the biochemical determinants of vascular volume in HF status, however, has not been known...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28664839/effects-of-paricalcitol-on-biomarkers-of-inflammation-and-fibrosis-in-kidney-transplant-recipients-results-of-a-randomized-controlled-trial
#9
Manca Oblak, Gregor Mlinšek, Aljoša Kandus, Jadranka Buturović-Ponikvar, Miha Arnol
AIMS: Paricalcitol, a selective vitamin D activator, decreases proteinuria and may reduce graft failure risk in kidney transplant recipients. In this study, we evaluated the effect of paricalcitol on renin-angiotensin system (RAS) activity as well as interleukin (IL)-6 and transforming growth factor (TGF)-β plasma concentrations as biomarkers of inflammation and fibrosis. METHODS: This placebo-controlled, double-blind trial enrolled a national cohort of kidney transplant recipients with urinary protein-to-creatinine ratio (UPCR) ≥ 20 mg/mmol despite optimization of the RAS blockade...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28661412/risk-of-new-onset-diabetes-mellitus-in-primary-aldosteronism-a-population-study-over-5-years
#10
Vin-Cent Wu, Shih-Chieh J Chueh, Likwang Chen, Chia-Hui Chang, Ya-Hui Hu, Yen-Hung Lin, Kwan-Dun Wu, Wei-Shiung Yang
OBJECTIVE: Abnormal glucose metabolism due to insulin resistance has been linked to aldosterone overproduction. However, the long-term incidence of new-onset diabetes mellitus (NODM) among patients with primary aldosteronism after targeted treatment has not been well documented. METHODS: The diagnosis of primary aldosteronism and essential hypertension were identified, and then the occurrence of NODM, all-cause mortality among these patients, was ascertained by a validated algorithm from a 23-million population insurance registry...
August 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28660991/insulin-resistance-in-endocrine-disorders-treatment-options
#11
Anita Rogowicz-Frontczak, Anna Majchrzak, Dorota Zozulińska-Ziółkiewicz
Changes in sensitivity to insulin occur in the course of a number of endocrine disorders. Most of the hormones through their antagonistic action to insulin lead to increased hepatic glucose output and its decreased utilisation in peripheral tissues. Carbohydrate disorders observed in endocrine diseases result from the phenomenon of insulin resistance, and in some cases also a reduction in insulin secretion is present. Abnormalities of glucose metabolism are observed in acromegaly, but also in growth hormone deficiency, hypercortisolism in the course of Cushing's syndrome, hyper- or hypothyroidism, primary hyperparathyroidism, aldosteronism, pheochromocytoma, congenital hypertrophy of the adrenal glands, polycystic ovaries syndrome, hypogonadism, or other hormonally active neuroendocrine tumours...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28657976/how-should-we-treat-patients-with-primary-aldosteronism-to-prevent-new-onset-diabetes-mellitus
#12
Hirofumi Hitomi, Akira Nishiyama
No abstract text is available yet for this article.
August 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28652474/rapid-screening-of-primary-aldosteronism-by-a-novel-chemiluminescent-immunoassay
#13
Ryo Morimoto, Yoshikiyo Ono, Yuta Tezuka, Masataka Kudo, Sachiko Yamamoto, Toshiaki Arai, Celso E Gomez-Sanchez, Hironobu Sasano, Sadayoshi Ito, Fumitoshi Satoh
Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents and detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results when measured by radioimmunoassay and development of more rapid assays has been long expected. We have developed chemiluminescent enzyme immunoassays enabling the simultaneous measurement of both aldosterone and renin concentrations in 10 minutes by a fully automated assay using antibody-immobilized magnetic particles with quick aggregation and dispersion...
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28652464/rapid-diagnosis-of-primary-aldosteronism-oxymoron-or-one-small-step
#14
EDITORIAL
Morris J Brown
No abstract text is available yet for this article.
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28647918/designing-future-clinical-trials-in-heart-failure-with-preserved-ejection-fraction-lessons-from-topcat
#15
REVIEW
Ravi B Patel, Sanjiv J Shah, Gregg C Fonarow, Javed Butler, Muthiah Vaduganathan
PURPOSE OF REVIEW: Spironolactone did not demonstrate benefit with respect to the primary composite endpoint in the global TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial in patients with chronic heart failure with preserved ejection fraction (HFpEF). We identify key lessons from the TOPCAT experience that can be applied to future HFpEF trials. RECENT FINDINGS: Subsequent analyses of TOPCAT have revealed marked regional heterogeneity in patient profiles, event rates, drug adherence, and treatment effects...
June 24, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28638984/associations-of-aldosterone-and-renin-concentrations-with-inflammation-the-study-of-health-in-pomerania-and-the-german-conn-s-registry
#16
A Grotevendt, H Wallaschofski, M Reincke, C Adolf, M Quinkler, M Nauck, W Hoffmann, R Rettig, A Hannemann
PURPOSE: Chronic inflammation is an age-independent and body mass index-independent contributor to the development of multi-morbidity. Alterations of the renin-angiotensin-aldosterone system are observed within the context of proinflammatory states. We assessed circulating aldosterone, renin, and inflammatory biomarker concentrations in healthy, normotensive subjects and patients with primary aldosteronism. METHODS: We included 1177 normotensive individuals from the population-based Study of Health in Pomerania (first follow-up, Study of Health in Pomerania-1) and 103 primary aldosteronism patients from the German Conn's Registry...
August 2017: Endocrine
https://www.readbyqxmd.com/read/28637881/physical-activity-and-prognosis-in-the-treatment-of-preserved-cardiac-function-heart-failure-with-an-aldosterone-antagonist-topcat-trial
#17
Sheila Hegde, Brian Claggett, Amil M Shah, Eldrin F Lewis, Inder S Anand, Sanjiv J Shah, Nancy K Sweitzer, James C Fang, Bertram Pitt, Marc A Pfeffer, Scott D Solomon
Background -Physical activity (PA) is inversely associated with adverse cardiovascular (CV) outcomes in healthy populations but the impact of physical activity in patients with heart failure with preserved ejection fraction (HFpEF) is less well characterized. Methods -The baseline self-reported PA of 1751 subjects enrolled in the Americas region of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial was categorized as poor, intermediate, or ideal PA using American Heart Association (AHA) criteria...
June 21, 2017: Circulation
https://www.readbyqxmd.com/read/28612447/obesity-and-the-diagnostic-accuracy-for-primary-aldosteronism
#18
Amit Tirosh, Fady Hannah-Shmouni, Charalampos Lyssikatos, Elena Belyavskaya, Mihail Zilbermint, Smita B Abraham, Maya B Lodish, Constantine A Stratakis
The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test...
June 13, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28594240/dimethylarginine-dimethylaminohydrolase-1-deficiency-induces-the-epithelial-to-mesenchymal-transition-in-renal-proximal-tubular-epithelial-cells-and-exacerbates-kidney-damage-in-aged-and-diabetic-mice
#19
Linlin Shi, Chenyang Zhao, Hongyun Wang, Tong Lei, Shasha Liu, Jianwei Cao, Zhongbing Lu
AIMS: Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is mainly degraded by dimethylarginine dimethylaminohydrolase (DDAH). Emerging evidence suggests that plasma ADMA accumulation and DDAH1 activity/expression reduction are linked to chronic kidney disease (CKD) pathology, but the mechanisms remain largely unknown. Here, we examined the role of ADMA/DDAH1 in the epithelial-mesenchymal transition (EMT) of tubular epithelial cells (TECs), an important mechanism for the pathogenesis of renal fibrosis...
July 7, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28592038/-the-application-of-captopril-challenge-test-in-the-diagnosis-of-primary-aldosteronism
#20
S Chen, Z P Zeng, A L Song, L Zhu, L Lu, A L Tong, C Shi, H Z Li
Objective: To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA). Methods: A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed. Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA). All patients received CCT. 24 h urine sodium was measured in partial patients...
June 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
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