Primary Aldosteronism and Drug Resistant Hypertension: A “Chicken-Egg” Story
Exp Clin Endocrinol Diabetes DOI: 10.1055/a-2073-3202Drug-resistant arterial hypertension (RH) is a major risk factor for
cardiovascular disease, often due to overlooked underlying causes.
Identification of such causes poses significant clinical challenges. In this
setting, primary aldosteronism (PA) is a frequent cause of RH and its prevalence
in RH patients is likely higher than 20%.The pathophysiological link between PA and the development and maintenance of RH
involves target organ damage and the cellular and extracellular effects of
aldosterone excess that promote pro-inflammatory and pro-fibrotic changes in the
kidney and vasculature.The feasibility of adrenal vein sampling in PA patients with RH, and the clinical
benefit achieved by adrenalectomy, further emphasize the need to implement
systematic screening for this common form of secondary hypertension in the
management of a high-risk population as RH patients.
We herein review the current knowledge of the factors that contribute to the RH
phenotype with a focus on PA and discuss the issues regarding the screening for
PA in this setting and the therapeutic approaches (surgical and medical) aimed
at resolving RH caused by PA. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents | Abstract | Full text
Source: Experimental and Clinical Endocrinology and Diabetes - Category: Endocrinology Authors: Lenzini, L Pintus, G Rossitto, G Seccia, T M Rossi, G P Tags: Review Source Type: research
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