Article
Peripheral Vascular Disease
Gregory L. Hundemer, Haris Imsirovic, Anand Vaidya, Nicholas Yozamp, Remi Goupil, Francois Madore, Mohsen Agharazii, Greg Knoll, Manish M. Sood
Summary: Primary aldosteronism is a common but highly underdiagnosed cause of hypertension that leads to disproportionately high rates of cardiovascular disease. However, the population-level uptake of guideline recommendations for primary aldosteronism screening is exceedingly low, highlighting the need for increased education and awareness to bridge this gap.
Article
Cardiac & Cardiovascular Systems
Adina F. Turcu, Winnie Nhan, Seda Grigoryan, Lei Zhang, Caitlin Urban, Haiping Liu, Lynn Holevinski, Lili Zhao
Summary: The study found that only a small subset of hypertensive patients underwent primary aldosteronism (PA) screening, which primarily occurred in patients with multiple risk factors and typically after the development of comorbidities.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Peripheral Vascular Disease
Gian Paolo Rossi, Filippo Crimi, Giacomo Rossitto, Laurence Amar, Michel Azizi, Anna Riester, Martin Reincke, Christoph Degenhart, Jiri Widimsky, Mitsuhide Naruse, Jaap Deinum, Leo Schultze Kool, Tomaz Kocjan, Aurelio Negro, Ermanno Rossi, Gregory Kline, Akiyo Tanabe, Fumitoshi Satoh, Lars Christian Rump, Oliver Vonend, Holger S. Willenberg, Peter J. Fuller, Jun Yang, Nicholas Yong Nian Chee, Steven B. Magill, Zulfiya Shafigullina, Marcus Quinkler, Anna Oliveras, Vin Cent Wu, Zuzana Kratka, Giulio Barbiero, Michele Battistel, Teresa Maria Seccia
Summary: Imaging can accurately identify unilateral primary aldosteronism in most young patients, especially those with a unilateral adrenal nodule and hypokalemia, but adrenal vein sampling is still necessary for patients without nodules/bilateral nodules or hypokalemia.
Article
Urology & Nephrology
Rebecca A. Boyle, Jessica E. Baker, Vivek Charu, William E. Rainey, Vivek Bhalla
Summary: This case study presents a unique presentation of Conn's syndrome in a young man with resistant hypertension and severe hypokalemia, eventually diagnosed as primary aldosteronism. Genetic studies revealed a gain-of-function KCNJ5 mutation within an aldosterone-producing adenoma that was responsive to changes in extracellular potassium levels, highlighting the implications for the molecular mechanisms of potassium regulation of aldosterone.
CLINICAL KIDNEY JOURNAL
(2021)
Article
Endocrinology & Metabolism
Chun-Kai Chang, Chin-Chen Chang, Vin-Cent Wu, Jiun-Hung Geng, Hsiang-Ying Lee
Summary: This study revealed a strong association between primary aldosteronism (PA) and renal stones, with PA-related renal stones being larger and harder than those in the essential hypertension group.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Biochemistry & Molecular Biology
Chung-Yi Cheng, Hung-Wei Liao, Kang-Yung Peng, Tso-Hsiao Chen, Yen-Hung Lin, Jeff S. Chueh, Vin-Cent Wu
Summary: The study investigated the clinical characteristics and surgical prognosis of GRA using data from the TAIPAI registry, finding specific clinical factors such as lower plasma aldosterone concentrations and aldosterone-renin ratios in GRA patients. Clinical predictors indicated that low serum potassium and high PRA may be associated with hypertension-remission in GRA patients.
Article
Biochemistry & Molecular Biology
Martina Bollati, Chiara Lopez, Fabio Bioletto, Federico Ponzetto, Ezio Ghigo, Mauro Maccario, Mirko Parasiliti-Caprino
Summary: Primary aldosteronism, the most common cause of secondary hypertension, not only affects blood pressure and electrolyte balance, but also has pro-inflammatory, pro-oxidant, and pro-fibrotic effects on the kidney, blood vessels, and heart, leading to potential harmful consequences. Clinical studies have shown that primary aldosteronism is associated with an increased risk of atrial fibrillation and aortic ectasia.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Endocrinology & Metabolism
Yi Chen, Xueyang Chen, Qiang Chen, Chaohui Yu
Summary: The prevalence of NAFLD is higher in PA patients compared to non-PA patients, with hypokalemic PA patients having a worse metabolic status. Although NAFLD is more common in PA patients, the patterns of obesity, dyslipidemia, and insulin resistance are similar. This study provides new insights for further investigations into metabolic imbalance in patients with aldosteronism.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Mirko Parasiliti-Caprino, Fabio Bioletto, Filippo Ceccato, Chiara Lopez, Martina Bollati, Maria Chiara Di Carlo, Giacomo Voltan, Denis Rossato, Giuseppe Giraudo, Carla Scaroni, Ezio Ghigo, Mauro Maccario
Summary: This study evaluated the reliability of simple and corrected aldosterone indices for assessing the selectivity and lateralization of adrenal vein sampling (AVS) in patients with primary aldosteronism. The results showed that the aldosterone index had high accuracy in predicting selectivity and moderate accuracy in predicting ipsi/contralateral aldosterone hypersecretion. The study also found that the use of corrected aldosterone indices significantly improved the accuracy in predicting ipsi/contralateral disease. The comparative aldosterone index showed high accuracy in predicting unilateral primary aldosteronism.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Nutrition & Dietetics
Niki Mourtzi, Amalia Sertedaki, Athina Markou, George P. Piaditis, Evangelia Charmandari
Summary: Recent genetic studies have made significant progress in understanding primary aldosteronism, with the identification of various mutations associated with both sporadic and familial forms of the disease. The prevalence of PA is higher than previously thought, highlighting the need for improved diagnostic tools and further research to identify milder forms of the condition and explore underlying molecular mechanisms.
Review
Cardiac & Cardiovascular Systems
Shivaraj Patil, Chaitanya Rojulpote, Aman Amanullah
Summary: Cardiovascular disease, especially ischemic heart disease, is a major global cause of illness and death. Primary aldosteronism is the main cause of secondary hypertension, but it is often under-diagnosed. Recent studies have shown that excessive production of aldosterone is associated with an increased risk of ischemic heart disease, which is disproportionate to the effects caused by hypertension alone. Understanding primary hyperaldosteronism and the distinctive pathophysiology of ischemic heart disease in this condition is crucial for improving outcomes.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Medicine, Research & Experimental
Jordana B. Cohen, Irina Bancos, Jenifer M. Brown, Harini Sarathy, Adina F. Turcu, Debbie L. Cohen
Summary: Primary aldosteronism (PA) is frequently overlooked and undertreated, despite being the most common cause of secondary hypertension. PA patients are at high risk for heart and kidney damage. While surgical treatment is an option for unilateral PA, many patients are not suitable or do not want surgery. Steroidal mineralocorticoid receptor antagonists (MRAs) effectively treat PA but are often underprescribed due to side effects. Nonsteroidal MRAs, on the other hand, reduce adverse renal and cardiovascular outcomes and are better tolerated. Their potential role in reducing target organ damage in PA patients, however, is still uncertain.
ANNUAL REVIEW OF MEDICINE
(2023)
Article
Endocrinology & Metabolism
Yujiro Nakano, Masanori Murakami, Kazunari Hara, Tatsuya Fukuda, Masato Horino, Akira Takeuchi, Yoshihiro Niitsu, Kumiko Shiba, Kazutaka Tsujimoto, Chikara Komiya, Minato Yokoyama, Kenji Ikeda, Takanobu Yoshimoto, Yasuhisa Fujii, Tetsuya Yamada
Summary: This study explores the effects of adrenalectomy or mineralocorticoid receptor antagonist treatment on the long-term renal function of primary aldosteronism patients with chronic kidney disease (CKD). The results indicate that treatment is safe and useful in preventing renal injury in stage 3 CKD patients with primary aldosteronism.
CLINICAL ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Adina F. Turcu, Jun Yang, Anand Vaidya
Summary: Primary aldosteronism is a common cause of hypertension and is associated with increased cardiovascular and renal morbidity and mortality. Despite its high prevalence and severe complications, primary aldosteronism is often overlooked.
NATURE REVIEWS ENDOCRINOLOGY
(2022)
Article
Peripheral Vascular Disease
Min Ru Chee, Jesse Hoo, Renata Libianto, Stella M. Gwini, Garun Hamilton, Om Narayan, Morag J. Young, Peter J. Fuller, Jun Yang
Summary: This study found a high prevalence of possible or likely primary aldosteronism among patients with both obstructive sleep apnea and hypertension, suggesting that they should be routinely screened for PA. No correlation was found between aldosterone, renin, or aldosterone:renin ratio and the apnea-hypopnea index, indicating the need for further research on the relationship between these conditions.
Article
Surgery
Joyce Lok Gee Ma, Vikash Yogaraj, Mustafa Siddiqui, Karanjeet Chauhan, Vicky A. Tobin, Charles H. C. Pilgrim
Summary: The impact of COVID-19 on emergency general surgery in Australia was investigated using emergency cholecystectomy as a representative operation. The study found an increase in emergency cholecystectomy during the COVID-19 period, but a decrease in after-hours surgery requirement.
ANZ JOURNAL OF SURGERY
(2022)