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Primary hyperaldosteronism presenting as persistent postpartum hypertension: Illustrative case and systematic review
Caitlin Kilmartin1, Touhid Opu2, Tiina Podymow3
1Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Obstetric Medicine
|December 20, 2019
Summary
Persistent postpartum hypertension can be secondary to primary hyperaldosteronism. This rare condition requires a high index of suspicion, especially with a history of hypertensive disorders of pregnancy.
Area of Science:
- Endocrinology
- Obstetrics & Gynecology
- Cardiovascular Medicine
Background:
- Primary hyperaldosteronism is a significant cause of secondary hypertension.
- Hypertensive disorders of pregnancy are common, but their association with primary hyperaldosteronism is under-recognized.
- Postpartum hypertension requires thorough investigation to identify underlying causes.
Observation:
- A case of persistent postpartum hypertension was diagnosed as secondary to primary hyperaldosteronism.
- The patient had a history of recurrent hypertensive disorders of pregnancy and fetal complications.
- A systematic review identified only 18 cases of primary aldosteronism in women with postpartum hypertension.
Findings:
- Primary hyperaldosteronism frequently presents with hypertensive disorders during pregnancy.
- Diagnosis of primary hyperaldosteronism may be delayed until the postpartum period.
- Obstetric history is crucial for suspecting primary hyperaldosteronism in postpartum hypertension.
Implications:
- Increased awareness and suspicion of primary hyperaldosteronism are needed in postpartum women with hypertension.
- Early diagnosis and management of primary hyperaldosteronism can prevent long-term cardiovascular complications.
- Further research is warranted to understand the prevalence and management of primary hyperaldosteronism in the postpartum population.
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