RSS-Feed abonnieren
DOI: 10.1055/a-1156-9926
Progress in Primary Aldosteronism 2019: New Players on the Block?
Funding: Additional grant support of the authors of this editorial are: the Else Kröner-Fresenius Stiftung (2013_A182, 2015_A171 and 2019_ A104 to MR) to M.R., the Deutsche Forschungsgemeinschaft to F.B. (BE2177/13-1), and to the European Research Council (grant number 694913 [PAPA] to M.R.).
Primary aldosteronism (PA) is characterized by hypertension caused by inappropriately high adrenal aldosterone secretion, consecutively low plasma renin, and an elevated aldosterone to renin ratio. It is nowadays the universally accepted main cause of endocrine hypertension. According to the most recent epidemiological data, PA is present in 5.8% of unselected hypertensives in primary care, 6–12% of hypertensives treated in hypertension centers, and up to 30% in subjects with resistant hypertension [1]. Despite this high prevalence, a recent survey demonstrated that screening for PA is not universally followed. Renin and aldosterone measurements, the basis for PA screening, are currently performed by only 7% of general practitioners in Italy and 8% in Germany [2]. Accordingly, the prevalence of PA was low with 1% among hypertensives in Italy and 2% in Germany. In a retrospective cohort study of 4660 patients with resistant hypertension in California the screening rate for PA was 2.1% [3]. Based on these data, it is clear that we still miss the majority of PA cases, despite advances in diagnosis and therapy.
Publikationsverlauf
Eingereicht: 07. April 2020
Angenommen: 08. April 2020
Artikel online veröffentlicht:
16. Juni 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Yang Y, Reincke M, Williams TA. Prevalence, diagnosis and outcomes of treatment for primary aldosteronism. Best Pract Res Clin Endocrinol Metab 2019; 101365 DOI: 10.1016/j.beem.2019.101365.. [Epub ahead of print]
- 2 Mulatero P, Monticone S, Burrello J. et al. Guidelines for primary aldosteronism: Uptake by primary care physicians in Europe. J Hypertens 2016; 34: 2253-2257
- 3 Jaffe G, Gray Z, Krishnan G. et al. Screening rates for primary aldosteronism in resistant. hypertension: A cohort study. Hypertension 2020; 75: 650-659
- 4 Monticone S, D’Ascenzo F, Moretti C. et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: A systematic review and meta-analysis. Lancet Diabetes Endocrinol 2018; 6: 41-50
- 5 Meng Z, Dai Z, Huang K. et al. Long-Term mortality for patients of primary aldosteronism compared with essential hypertension: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2020; 11: 121
- 6 Gruber S, Beuschlein F. Hypokalemia and the prevalence of primary aldosteronism. Horm Metab Res 2020; 52: 347-356
- 7 Pan C-T, Tsai C-H, Chen Z-W. et al. Atrial fibrillation in primary aldosteronism. Horm Metab Res 2020; 52: 357-365
- 8 Pecori A, Buffolo F, Pieroni J. et al. Primary aldosteronism and obstructive sleep apnea: casual association or pathophysiological link?. Horm Metab Res 2020; 52: 366-372
- 9 Wannachalee T, Turcu AF. Developments in primary aldosteronism subtyping using steroid profiling. Horm Metab Res 2020; 52: 373-378
- 10 Meyer LS, Gong S, Reincke M. et al. Angiotensin II type 1 receptor autoantibodies in primary aldosteronism. Horm Metab Res 2020; 52: 379-385
- 11 Adolf C, Schneider H, Heinrich DA. et al. Salt appetite and its effects on cardiovascular risk in primary aldosteronism. Horm Metab Res 2020; 52: 386-393
- 12 Tömböl Z, Turai PI, Decmann A. et al. MicroRNAs and adrenocortical tumors: Where do we stand on primary aldosteronism?. Horm Metab Res 2020; 52: 394-403
- 13 Handgriff L, Adolf C, Heinrich DA. et al. The impact of glucocorticoid co-secretion in primary aldosteronism on thyroid autoantibody titers during the course of disease. Horm Metab Res 2020; 52: 404-411
- 14 Lopez A-G, Duparc C, Naccache A. et al. Role of mast cells in the control of aldosterone secretion. Horm Metab Res 2020; 52: 412-420
- 15 Gomez-Sanchez CE, Gomez-Sanchez EP, Nishimoto K. Immunohistochemistry of the human adrenal CYP11B2 in normal individuals and in patients with primary aldosteronism. Horm Metab Res 2020; 52: 421-426
- 16 Lim JS, Rainey WE. The potential role of aldosterone-producing cell clusters in adrenal disease. Horm Metab Res 2020; 52: 427-434
- 17 Li F, Feuchtinger A, Walch A. et al. In situ metabolite mass spectrometry imaging: New insights into the adrenal gland. Horm Metab Res 2020; 52: 435-447
- 18 Gao X, Yamazaki Y, Tezuka Y. et al. The effect of extracellular calcium metabolism on aldosterone biosynthesis in physiological and pathological status. Horm Metab Res 2020; 52: 448-453
- 19 Naruse M, Yamamoto K, Katabami T. et al. Age, gender, and body mass index as determinants of surgical outcome in primary aldosteronism. Horm Metab Res 2020; 52: 454-548
- 20 Funder JW. Primary aldosteronism: Where are we now? Where to from here?. Horm Metab Res 2020; 52: 459-466