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A Novel Method: Super-selective Adrenal Venous Sampling

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Published on: September 15, 2017

Primary aldosteronism: emerging trends.

Sandi-Jo Galati¹, Sarah M Hopkins, Khadeen C Cheesman

¹Division of Endocrinology, Metabolism and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, Adrenal Center at Mount Sinai Hospital, 1 Gustave L. Levy Place, #1055, New York, NY 10029, USA.

Trends in Endocrinology and Metabolism: TEM

|June 26, 2013

Summary

This summary is machine-generated.

Primary aldosteronism (PA), a common cause of endocrine hypertension, is often under-diagnosed. Screening with the aldosterone:renin ratio (ARR) and confirmatory tests like adrenal venous sampling (AVS) are crucial for effective management.

Keywords:

aldosterone hypertension primary aldosteronism renin resistant hypertension

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Area of Science:

Endocrinology
Cardiology
Hypertension Research

Background:

Primary aldosteronism (PA) is the leading cause of endocrine hypertension (HTN).
Recent studies indicate PA may be under-diagnosed, with expanded screening criteria due to non-classical presentations (e.g., absence of hypokalemia) and familial forms.
The aldosterone:renin ratio (ARR) is the primary screening tool for PA.

Purpose of the Study:

To review the diagnostic approach to primary aldosteronism.
To highlight the importance of expanded screening and diagnostic methods.
To emphasize the benefits of targeted therapy for PA.

Main Methods:

Discussion of the aldosterone:renin ratio (ARR) as a screening test.
Explanation of adrenal venous sampling (AVS) for lateralization.
Review of current understanding of PA prevalence and diagnosis.

Main Results:

The ARR is a reliable screening test for PA, interpretable on most antihypertensive medications.
Adrenal venous sampling (AVS) is essential for differentiating unilateral adenomas from bilateral disease when surgical intervention is considered.
Targeted medical or surgical therapies significantly improve patient outcomes in PA.

Conclusions:

Primary aldosteronism is a prevalent and often overlooked cause of hypertension.
Early and accurate diagnosis through ARR and AVS is critical.
Effective management strategies, including surgery or medication, lead to improved patient health outcomes.