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Primary aldosterone

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https://www.readbyqxmd.com/read/27917596/plasma-adrenocorticotropic-hormone-but-not-aldosterone-is-correlated-with-blood-pressure-in-patients-with-aldosterone-producing-adenomas
#1
Hiroki Kobayashi, Akira Haketa, Ueno Takahiro, Hiromasa Otsuka, Sho Tanaka, Yoshinari Hatanaka, Yukihiro Ikeda, Masanori Abe, Noboru Fukuda, Masayoshi Soma
Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. The authors examined the levels of aldosterone, cortisol, renin, and adrenocorticotropic hormone (ACTH) measured at 12 am, 6 am, 12 pm, and 6 pm and BP in the early morning (6 am to 7 am), late morning (9 am to 11 am), and early evening (5 pm to 7 pm)...
December 5, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27917573/role-of-adrenocorticotropic-hormone-in-essential-hypertension-and-primary-aldosteronism
#2
Decio Armanini, Alessandra Andrisani, Guido Ambrosini, Luciana Bordin, Chiara Sabbadin
No abstract text is available yet for this article.
December 5, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27906749/sodium-and-potassium-in-the-pathogenesis-of-hypertension-focus-on-the-brain
#3
Horacio J Adrogué, Nicolaos E Madias
PURPOSE OF REVIEW: Primary hypertension is characterized by Na excess and K deficit in the body, which together are key to its pathogenesis. These derangements work jointly in the brain and the peripheral vascular wall to establish hypertension. In this review, we highlight recent evidence describing the central mechanisms through which Na surfeit and K deficit enhance sympathetic nerve activity, thereby raising peripheral vascular resistance and generating hypertension. RECENT FINDINGS: Animal studies point to a small increase in plasma and cerebrospinal fluid (CSF) [Na], a small decrease in CSF [K], and increased levels of circulating angiotensin II, aldosterone, and endogenous ouabain as the central signals evoking hypertension...
December 2, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27902632/high-sensitive-c-reactive-protein-in-primary-aldosteronism
#4
Masayuki Tanemoto
No abstract text is available yet for this article.
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27893293/prevelence-of-primary-aldosteronism-in-an-urban-hypertensive-population
#5
Sandi-Jo Galati, Khadeen C Cheesman, Ryan Springer-Miller, Sarah M Hopkins, Lawrence Krakoff, Emilia Bagiella, Rachel A Zhuk, Tiffany K Ying, Chelsey Amer, Michael K Boyajian, W B Inabnet, Alice C Levine
OBJECTIVE: To determine the prevalence of primary aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA. METHODS: An aldosterone:renin ratio (ARR, cutoff ≥20, with plasma aldosterone concentration [PAC] ≥10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (blood pressure [BP] ≥140/90) over the age of 18 from August 2012 through May 2013...
November 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27878955/primary-aldosteronism-from-case-detection-to-histopathology-with-up-to-6%C3%A2-years-of-follow-up
#6
Gudbjörg Jonsdottir, Jon Gudmundsson, Gudjon Birgisson, Helga Agusta Sigurjonsdottir
The authors aimed to investigate the clinical characteristics, accuracy of diagnostic tests, and long-term outcomes after interventions in patients diagnosed with primary aldosteronism (PA) in Iceland throughout 5 years. A retrospective chart review was performed for all patients diagnosed with PA during the years 2007-2011 at Landspitali Hospital in Iceland, a referral center for the whole country. Workup after detection included salt loading test, positional test, computed tomography, and adrenal vein sampling...
November 23, 2016: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/27878800/a-single-center-experience-of-the-implementation-of-adrenal-vein-sampling-procedure-impact-on-the-diagnostic-work-up-in-primary-aldosteronism
#7
Jacek Kądziela, Aleksander Prejbisz, Ilona Michałowska, Sylwia Kołodziejczyk-Kruk, Leo Schultze Kool, Marek Kabat, Hanna Janaszek-Sitkowska, Sadegh Toutounchi, Zbigniew Gałązka, Urszula Ambroziak, Tomasz Bednarczuk, Magdalena Januszewicz, Dorota Ptasińska-Wnuk, Michał Hoffmann, Andrzej Januszewicz, Adam Witkowski
BACKGROUND AND AIM: Primary aldosteronism (PA) is one of the most common causes of secondary hypertension. Adrenal vein sampling (AVS) remains a "gold standard" procedure in differentiation between unilateral (adenoma) and bilateral (hyperplasia) disease. We present our single-center experience in establishing and implementation of the AVS procedure. METHODS: All patients had primary aldosteronism confirmed in salt-infusion test. Adrenal vein sampling was performed sequentially during a continuous intravenous infusion of cosyntropin and was preceded by multislice contrast-enhanced computed tomography (CT) examination of adrenal glands performed few weeks before AVS in majority of patients...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27876824/non-stimulated-adrenal-venous-sampling-using-dyna-computed-tomography-in-patients-with-primary-aldosteronism
#8
Chin-Chen Chang, Bo-Ching Lee, Kao-Lang Liu, Yeun-Chung Chang, Vin-Cent Wu, Kuo-How Huang
In this retrospective study, we aimed to examine the effect of applying Dyna computed tomography (CT) on the success rate of adrenal venous sampling (AVS) without adrenocorticotropic hormone stimulation. A total of 100 consecutive patients with primary aldosteronism who underwent AVS between May 2012 and July 2015 were enrolled. In all the cases, Dyna CT was used in AVS to validate catheter position in the right adrenal vein. A selectivity index (cortisoladrenal vein /cortisolinferior vena cava) of ≥2.0 of both adrenal veins were required for successful AVS...
November 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27872977/hypertension-cure-following-laparoscopic-adrenalectomy-for-hyperaldosteronism-is-not-universal-trends-over-two-decades
#9
Takeshi Namekawa, Takanobu Utsumi, Tomoaki Tanaka, Mayuko Kaga, Hidekazu Nagano, Takashi Kono, Koji Kawamura, Naoto Kamiya, Takashi Imamoto, Hiroyoshi Suzuki, Tomohiko Ichikawa
BACKGROUND: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades. METHODS: This retrospective clinical study included 176 patients who underwent unilateral laparoscopic adrenalectomy for primary aldosteronism from 1995 to 2015...
November 21, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27872236/preclinical-and-early-clinical-profile-of-a-highly-selective-and-potent-oral-inhibitor-of-aldosterone-synthase-cyp11b2
#10
Katrijn Bogman, Dietmar Schwab, Marie-Laure Delporte, Giuseppe Palermo, Kurt Amrein, Susanne Mohr, Maria Cristina De Vera Mudry, Morris J Brown, Philippe Ferber
Primary hyperaldosteronism is a common cause of resistant hypertension. Aldosterone is produced in the adrenal by aldosterone synthase (AS, encoded by the gene CYP11B2). AS shares 93% homology to 11β-hydroxylase (encoded by the gene CYP11B1), responsible for cortisol production. This homology has hitherto impeded the development of a drug, which selectively suppresses aldosterone but not cortisol production, as a new treatment for primary hyperaldosteronism. We now report the development of RO6836191 as a potent (Ki 13 nmol/L) competitive inhibitor of AS, with in vitro selectivity >100-fold over 11β-hydroxylase...
November 21, 2016: Hypertension
https://www.readbyqxmd.com/read/27869719/targeted-molecular-imaging-in-adrenal-disease-an-emerging-role-for-metomidate-pet-ct
#11
REVIEW
Iosif A Mendichovszky, Andrew S Powlson, Roido Manavaki, Franklin I Aigbirhio, Heok Cheow, John R Buscombe, Mark Gurnell, Fiona J Gilbert
Adrenal lesions present a significant diagnostic burden for both radiologists and endocrinologists, especially with the increasing number of adrenal 'incidentalomas' detected on modern computed tomography (CT) or magnetic resonance imaging (MRI). A key objective is the reliable distinction of benign disease from either primary adrenal malignancy (e.g., adrenocortical carcinoma or malignant forms of pheochromocytoma/paraganglioma (PPGL)) or metastases (e.g., bronchial, renal). Benign lesions may still be associated with adverse sequelae through autonomous hormone hypersecretion (e...
November 18, 2016: Diagnostics
https://www.readbyqxmd.com/read/27866529/-a-fisher-discriminant-model-to-predict-the-outcome-of-postoperative-blood-pressure-in-primary-aldosteronism
#12
X Q He, S Yang, J L Wu, D L Wang, W Ren, Q F Cheng, Q N Zhen, Y D Cao, Q F Li, B Zhou
Objective: To establish a Fisher discriminant model in order to predict the outcome of postoperative blood pressure for primary aldosteronism (PA). Methods: A total of 83 cases from the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into two groups: cure group and not cure group according to postoperative blood pressure. Fisher stepwise discriminant analysis was used to establish a discriminant model, and compared with aldosteronoma resolution score (ARS) and nomogram model by receiver operating characteristic curve...
November 15, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27864805/endocrine-hypertension-a-practical-approach
#13
REVIEW
Joseph M Pappachan, Harit N Buch
Elevated blood pressure resulting from few endocrine disorders (endocrine hypertension) accounts for a high proportion of cases of secondary hypertension. Although some features may be suggestive, many cases of endocrine hypertension remain silent until worked up for the disease. A majority of cases result from primary aldosteronism. Other conditions that can cause endocrine hypertension are: congenital adrenal hyperplasia, Liddle syndrome, pheochromocytomas, Cushing's syndrome, acromegaly, thyroid diseases, primary hyperparathyroidism and iatrogenic hormone manipulation...
November 19, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27862984/of-channels-and-pumps-different-ways-to-boost-the-aldosterone
#14
REVIEW
Sascha Bandulik
The mineralocorticoid aldosterone is a major factor controlling the salt and water balance and thereby also the arterial blood pressure. Accordingly, primary aldosteronism characterized by an inappropiately high aldosterone secretion is the most common form of secondary hypertension. The physiological stimulation of aldosterone synthesis in adrenocortical glomerulosa cells by angiotensin II and an increased plasma K(+) concentration depends on a membrane depolarization and an increase of the cytosolic Ca(2+) activity...
November 15, 2016: Acta Physiologica
https://www.readbyqxmd.com/read/27862274/risk-of-fracture-in-primary-aldosteronism-a-population-based-cohort-study
#15
Vin-Cent Wu, Chia-Hui Chang, Cheng-Yi Wang, Yen-Hung Lin, Tze-Wah Kao, Po-Chih Lin, Tzong-Shinn Chu, Yuan-Shian Chang, Likwang Chen, Kwan-Dun Wu, Shih-Chieh Jeff Chueh
Primary aldosteronism (PA) is associated with increased urinary calcium excretion and osteoporosis prevalence. We studied the long-term effect of hyperaldosterone on fracture risk and possible risk mitigation via treatments, by comparing PA patients and their essential hypertension (EH) counterparts extracted by propensity score match. We used a longitudinal population database from the Taiwan National Health Insurance, and used a validated algorithm to identify PA patients diagnosed in 1997-2010. Our sample included 2533 PA patients, including 921 patients with aldosterone-producing adenoma (APA)...
November 10, 2016: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/27862131/scoring-system-for-the-diagnosis-of-bilateral-primary-aldosteronism-in-the-outpatient-setting-before-adrenal-venous-sampling
#16
Hiroki Kobayashi, Akira Haketa, Takahiro Ueno, Yukihiro Ikeda, Yoshinari Hatanaka, Sho Tanaka, Hiromasa Otsuka, Masanori Abe, Noboru Fukuda, Masayoshi Soma
OBJECTIVE: The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS. DESIGN: We retrospectively analysed 82 patients who were diagnosed with PA and underwent AVS...
November 8, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27861246/adrenal-venous-sampling-in-primary-aldosteronism-multinomial-regression-modeling-to-detect-aldosterone-secretion-lateralization-when-right-adrenal-sampling-is-missing
#17
Camille Durivage, Rémi Blanchette, Gilles Soulez, Miguel Chagnon, Patrick Gilbert, Marie-France Giroux, Isabelle Bourdeau, Vincent L Oliva, André Lacroix, Eric Therasse
OBJECTIVE: Difficulty to recognize or canulate the right adrenal vein is the most frequent cause of adrenal venous sampling (AVS) failure. We aimed to assess multinomial regression modeling (MRM) of peripheral and left adrenal vein samplings to detect lateralization of aldosterone secretion when the right AVS is missing. METHODS: Simultaneous bilateral AVS samplings were performed before (basal) and after intravenous cosyntropin injection in 188 consecutive patients between December 1989 and September 2015...
November 16, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27857838/hyponatraemia-secondary-to-nivolumab-induced-primary-adrenal-failure
#18
Harris Trainer, Paul Hulse, Claire E Higham, Peter Trainer, Paul Lorigan
: Checkpoint inhibitors, such as ipilimumab and pembrolizumab, have transformed the prognosis for patients with advanced malignant melanoma and squamous non-small-cell lung cancer, and their use will only expand as experience is gained in a variety of other malignancies, for instance, renal and lymphoma. As the use of checkpoint inhibitors increases, so too will the incidence of their unique side effects, termed immune-related adverse events (irAEs), which can affect dermatological, gastrointestinal, hepatic, endocrine and other systems...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27853054/expression-of-cyp11b2-in-aldosterone-producing-adrenocortical-adenoma-regulatory-mechanisms-and-clinical-significance
#19
Yasuhiro Nakamura, Yuto Yamazaki, Yuta Tezuka, Fumitoshi Satoh, Hironobu Sasano
Aldosterone-producing adrenocortical adenoma (APA) is responsible for the majority of cases clinically diagnosed as primary aldosteronism. Aldosterone synthase (CYP11B2) is one of the enzymes that play essential roles in aldosterone synthesis and is involved in the pathogenesis of APA. Recent studies have demonstrated that various factors and regulators influence the expression and function of CYP11B2 in APA. In particular, somatic mutations, such as gain-of-function and loss-of-function mutations, have been identified in several genes, each of which encodes a pivotal protein that affects the calcium signaling pathway, the expression of CYP11B2, and aldosterone production...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27836950/adrenal-vein-sampling-in-primary-aldosteronism-concordance-of-simultaneous-vs-sequential-sampling
#20
Mohamed-Karji Almarzooqi, Miguel Chagnon, Gilles Soulez, Marie-France Giroux, Patrick Gilbert, Vincent L Oliva, Pierre Perreault, Louis Bouchard, Isabelle Bourdeau, André Lacroix, Eric Therasse
OBJECTIVE: Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods. DESIGN AND METHODS: Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53.4 years). Selectivity was defined by adrenal-to-peripheral cortisol ratio ≥2, and lateralization was defined as an adrenal aldosterone-to-cortisol ratio ≥2, the contralateral side...
February 2017: European Journal of Endocrinology
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