Primary aldosteronism -- screening, diagnosis and therapy

Area of Science:

• Endocrinology
• Nephrology
• Cardiology

Background:

• Primary aldosteronism (PA) is a significant cause of secondary hypertension.
• Accurate diagnosis and subtype differentiation are crucial for effective management.
• Current diagnostic criteria require refinement for broader clinical application.

Purpose of the Study:

• To establish clear criteria for screening, diagnosis, and therapy of primary aldosteronism.
• To analyze the diagnostic value of specific clinical and biochemical markers.
• To differentiate between aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA).

Main Methods:

• Analysis of symptoms and biochemical data in 40 PA patients.
• Screening of 970 hypertensive patients for PA.
• Adrenal phlebography with plasma aldosterone concentration (PAC) measurement in adrenal veins.

Main Results:

• PA was diagnosed in 4.12% of hypertensive patients.
• Key screening indicators include polyuria, hypokalemia, and alkalosis.
• Adrenal phlebography successfully differentiated APA from IHA based on PAC levels.

Conclusions:

• Defined screening, diagnosis, and therapy criteria for PA.
• Unilateral adrenalectomy effectively treated hypertension in APA patients.
• Spironolactone is a vital therapeutic option for both APA and IHA.