Primary aldosteronism

Sean M Wrenn; Anand Vaidya; Carrie C Lubitz

doi:10.21037/gs.2019.10.23

Primary aldosteronism

Gland Surg. 2020 Feb;9(1):14-24. doi: 10.21037/gs.2019.10.23.

Authors

Sean M Wrenn^{1

2}, Anand Vaidya³, Carrie C Lubitz¹

Affiliations

¹ Department of General Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Department of General Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
³ Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

Primary aldosteronism (PA) is a common cause of secondary hypertension caused by excessive and inappropriate secretion of the hormone aldosterone from one or both adrenal glands. The prevalence of PA ranges from 10% in the general hypertensive population to 20% in resistant hypertension, yet only a small fraction of patients is diagnosed. Disease and symptom recognition, screening in indicated populations, multidisciplinary communication, and appropriate imaging and biochemical workup can identify patients who might benefit from effective and targeted treatment modalities. Effective treatments available include both surgical and medical approaches, usually dependent on the subtype of PA present. Our collective understanding of the pathophysiology of PA is expanded by recent developments in molecular biology and genetics, including understanding the specific somatic and germline mutations involved in pathogenesis. We review the pathophysiology, diagnostic workup, and treatment considerations for this disease process.

Keywords: Conn’s syndrome; Primary aldosteronism (PA); adrenal adenoma; adrenal gland; endocrine; endocrine surgery.

Publication types

Review