The changing clinical spectrum of primary aldosteronism

Bravo, Emmanuel L.; Tarazi, Robert C.; Dustan, Harriet P.; Fouad, Fetnat M.; Textor, Stephen C.; Gifford, Ray W.; Vidt, Donald G.

doi:10.1016/0002-9343(83)91022-7

Cited by 277 publications

(119 citation statements)

References 33 publications

Supporting

Mentioning

107

Contrasting

Unclassified

Order By: Relevance

“…4 To overcome this problem, a functional definition of PA has been adopted, ie the failure of plasma aldosterone to suppress in response to salt loading which confirms the diagnosis without the need to have clearly elevated levels of plasma or urinary aldosterone. 3,[5][6][7][8] Not surprisingly, this broader definition has caused some controversy, as many more hypertensive patients are included within the bracket of PA, who would in the past have been labelled under the descriptive heading of 'low renin' essential hypertension (LREH).…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Since hypertension could be cured by removing a Conn's adenoma, the emphasis was to look for PA with this specific aetiology in mind. This ignored bilateral adrenal hyperplasia (or idiopathic hyperaldosteronism (IHA)) which was less amenable to surgical treatment unless functional lateralisation could be demonstrated, 11,12 despite being another common cause of PA.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is aldosterone the missing link in refractory hypertension?: aldosterone-to-renin ratio as a marker of inappropriate aldosterone activity

2002

View full text Add to dashboard Cite

Use of the random aldosterone-to-renin ratio (ARR) as a reliable marker of inappropriate aldosterone activity has led to primary aldosteronism (PA) being increasingly diagnosed in hypertensive patients. At least 10% of hypertensives have been found to have PA, the majority of whom presumably have bilateral adrenal hyperplasia or idiopathic hyperaldosteronism as an aetiology for PA. Whilst these patients clearly have excess aldosterone activity, they have in common many features that are found in hypertensive patients in general, amongst which include heightened angiotensin II adre-

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is aldosterone the missing link in refractory hypertension?: aldosterone-to-renin ratio as a marker of inappropriate aldosterone activity

2002

View full text Add to dashboard Cite

show abstract

“…She had suppressed PRA at the time of diagnosis, which became elevated and non-suppressible by intravenous salt loading. While raised PRA has been reported previously in primary aldosteronism, 1 spontaneous rise in PRA from suppressed levels in any one patient with primary aldosteronism is unusual. We discuss the various pathophysiological processes that may have resulted in this change.…”

Section: Introductionmentioning

confidence: 53%

High and non-suppressible plasma renin activity in a patient with aldosterone producing adenoma: pathophysiologic and diagnostic implications

Tai

Eng

1999

J Hum Hypertens

View full text Add to dashboard Cite

show abstract

“…2 Subsequently it was shown to be inherited in an autosomal dominant fashion and approximately 100 cases were reported in the world literature up to the early 1990's. [3][4][5][6][7][8][9] The most common presentation of GRA used to be the discovery of asymptomatic severe hypertension, especially in infancy or early adulthood. With the ability to identify individuals by genetic or biochemical testing, much milder or earlier clinical forms are being described.…”

mentioning

confidence: 99%

“…However, the clinical spectrum of this disorder is heterogeneous, with up to 50% of all cases having normal serum potassium levels, and others having apparently 'normal' BP. 4,7,10 In GRA, the renin-angiotensin system is suppressed; aldosterone levels are either elevated or normal and is exclusively regulated by ACTH, rather than the normal principal secretogogue, angiotensin II. As a result, plasma aldosterone levels do not increase and plasma renin activity (PRA) remains suppressed in response to upright posture or to an infusion of angiotensin II.…”

mentioning

confidence: 99%

Monogenic forms of mineralocorticoid hypertension: insights into the pathogenesis of ‘essential’ hypertension?

Petrelli

Stewart

1998

J Hum Hypertens

View full text Add to dashboard Cite

Hypertension is a common condition, which, depending on its definition, affects 10-25% of the population. Because it is an established risk factor for coronary and cerebrovascular disease, hypertension has, quite rightly, been targeted as an important factor in determining the health of the nation. Despite this we can explain the underlying cause of a patient's hypertension in Ͻ5% of cases; the remainder are labelled 'essential' hypertension, an elegant way of stating that the aetiology is unknown. As a result, in the vast majority of cases treatment is given on an empirical basis.In the last 5 years, significant advances have been made in our understanding of the pathogenesis of hypertension with the characterisation of three forms of inherited hypertension. All arise because of distinct, single gene mutations but can result in the same phenotype, that of mineralocorticoid hypertension. The purpose of this article is to review these 'monogenic' forms of mineralocorticoid hypertension, glucocorticoid-remediable hyperaldosteronism, Liddle's syndrome and apparent mineralocorticoid excess, and to discuss their significance to the broader population with essential hypertension.Glucocorticoid remediable aldosteronism (GRA) (also referred to as dexamethasone suppressible hyperaldosteronism or glucocorticoidsuppressible hyperaldosteronism)In 1966 a hypertensive father and son were described with a new disorder that mimicked priCorrespondence: PM Stewart, Professor

show abstract

The changing clinical spectrum of primary aldosteronism

Cited by 277 publications

References 33 publications

Is aldosterone the missing link in refractory hypertension?: aldosterone-to-renin ratio as a marker of inappropriate aldosterone activity

Is aldosterone the missing link in refractory hypertension?: aldosterone-to-renin ratio as a marker of inappropriate aldosterone activity

High and non-suppressible plasma renin activity in a patient with aldosterone producing adenoma: pathophysiologic and diagnostic implications

Monogenic forms of mineralocorticoid hypertension: insights into the pathogenesis of ‘essential’ hypertension?

Contact Info

Product

Resources

About