Horm Metab Res 2015; 47(13): 933-934
DOI: 10.1055/s-0035-1565125
Editorial

Progress in Primary Aldosteronism: Translation on the Move

M. Reincke
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
,
F. Beuschlein
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
› Author Affiliations

Hypertension is a major cardiovascular risk factor that affects between 10–40% of the general population in an age dependent manner. The renin-angiotensin-aldosterone system (RAAS) regulates blood pressure, fluid volume, and the vascular response to injury and inflammation [1]. Chronic RAAS activation in the presence of sufficient sodium consumption leads to persistent hypertension, setting off a cascade of inflammatory, thrombotic, and atherogenic effects eventually leading to end-organ damage [2] [3]. Accordingly, numerous studies have demonstrated that elevated renin and/or aldosterone levels are predictors of adverse outcome in hypertension [4], heart failure [5] [6], myocardial infarction [7], and renal insufficiency [8] and influence insulin resistance [9]. Primary aldosteronism (PA) is the most common secondary form of hypertension with an estimated prevalence between 4 and 12% of hypertensives [10] [11] [12] and 11–20% in patients that are resistant to combined antihypertensive medication [13] [14]. Given the severe cardiovascular adverse effects of aldosterone excess that are independent of high blood pressure levels [15] [16] [17] [18] detection and treatment of PA has important impact on clinical outcome and survival.



Publication History

Received: 14 October 2015

Accepted: 15 October 2015

Article published online:
14 December 2015

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Ferrario CM. Role of angiotensin II in cardiovascular disease therapeutic implications of more than a century of research. J Renin Angiotensin Aldosterone Syst 2006; 7: 3-14
  • 2 Brewster UC, Setaro JF, Perazella MA. The renin-angiotensin-aldosterone system: cardiorenal effects and implications for renal and cardiovascular disease states. Am J Med Sci 2003; 326: 15-24
  • 3 Cooper ME. The role of the renin-angiotensin-aldosterone system in diabetes and its vascular complications. Am J Hypertens 2004; 17 (11) 16S-20S quiz A2–4
  • 4 Vasan RS, Evans JC, Larson MG, Wilson PW, Meigs JB, Rifai N, Benjamin EJ, Levy D. Serum aldosterone and the incidence of hypertension in nonhypertensive persons. N Engl J Med 2004; 351: 33-41
  • 5 Tsutamoto 1 T, Sakai H, Tanaka T, Fujii M, Yamamoto T, Wada A, Ohnishi M, Horie M. Comparison of active renin concentration and plasma renin activity as a prognostic predictor in patients with heart failure. Circ J 2007; 71: 915-921
  • 6 Güder G, Bauersachs J, Frantz S, Weismann D, Allolio B, Ertl G, Angermann CE, Störk S. Complementary and incremental mortality risk prediction by cortisol and aldosterone in chronic heart failure. Circulation 2007; 115: 1754-1761
  • 7 Beygui F, Collet JP, Benoliel JJ, Vignolles N, Dumaine R, Barthélémy O, Montalescot G. High plasma aldosterone levels on admission are associated with death in patients presenting with acute ST-elevation myocardial infarction. Circulation 2006; 114: 2604-2610
  • 8 Tylicki L, Larczynski W, Rutkowski B. Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney Blood Press Res 2005; 28: 230-242
  • 9 Freel EM, Tsorlalis IK, Lewsey JD, Latini R, Maggioni AP, Solomon S, Pitt B, Connell JM, McMurray JJ. Aldosterone status associated with insulin resistance in patients with heart failure – data from the ALOFT study. Heart 2009; 95: 1920-1924
  • 10 Mulatero P, Stowasser M, Loh KC, Fardella CE, Gordon RD, Mosso L, Gomez-Sanchez CE, Veglio F, Young Jr WF. Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab 2004; 89: 1045-1050
  • 11 Plouin PF, Amar L, Chatellier G. Trends in the prevalence of primary aldosteronism, aldosterone-producing adenomas, and surgically correctable aldosterone-dependent hypertension. Nephrol Dial Transplant 2004; 19: 774-777
  • 12 Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, Ganzaroli C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Mattarello MJ, Moretti A, Palumbo G, Parenti G, Porteri E, Semplicini A, Rizzoni D, Rossi E, Boscaro M, Pessina AC, Mantero F. PAPY Study Investigators. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol 2006; 48: 2293-2300
  • 13 Calhoun DA, Nishizaka MK, Zaman MA, Thakkar RB, Weissmann P. Hyperaldosteronism among black and white subjects with resistant hypertension. Hypertension 2002; 40: 892-896
  • 14 Douma S, Petidis K, Doumas M, Papaefthimiou P, Triantafyllou A, Kartali N, Papadopoulos N, Vogiatzis K, Zamboulis C. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet 2008; 371: 1921-1926
  • 15 Milliez P, Girerd X, Plouin PF, Blacher J, Safar ME, Mourad JJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol 2005; 45: 1243-1248
  • 16 Catena C, Colussi G, Nadalini E, Chiuch A, Baroselli S, Lapenna R, Sechi LA. Cardiovascular outcomes in patients with primary aldosteronism after treatment. Arch Intern Med 2008; 168: 80-85
  • 17 Sechi LA, Colussi G, Di Fabio A, Catena C. Cardiovascular and renal damage in primary aldosteronism: outcomes after treatment. Am J Hypertens 2010; 23: 1253-1260
  • 18 Rossi GP, Bernini G, Desideri G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mannelli M, Matterello MJ, Montemurro D, Palumbo G, Rizzoni D, Rossi E, Pessina AC, Mantero F. PAPY Study Participants. Renal damage in primary aldosteronism: results of the PAPY Study. Hypertension 2006; 48: 232-238
  • 19 Nishimoto K, Tomlins SA, Kuick R, Cani AK, Giordano TJ, Hovelson DH, Liu CJ, Sanjanwala AR, Edwards MA, Gomez-Sanchez CE, Nanba K, Rainey WE. Aldosterone-stimulating somatic gene mutations are common in normal adrenal glands. Proc Natl Acad Sci USA 2015; 112: E4591-E4599
  • 20 Fernandes-Rosa FL, Giscos-Dourie I, Amar L, Gomez-Sanchez CE, Meatchi T, Boulkroun S, Zennaro MC. Different somatic mutations in multinodular adrenals with aldosterone-producing adenoma. Hypertension 2015; 66: 1014-1022
  • 21 Williams TA, Peitzsch M, Dietz AS, Dekkers T, Bidlingmaier M, Riester A, Treitl M, Rhayem Y, Beuschlein F, JWM Lenders, Deinum J, Eisenhofer G, Reincke M. Genotype-specific steroid profiles associated with aldosterone-producing adenomas. Hypertension. in press
  • 22 Funder JW. Primary aldosteronism: new answers, new questions. Horm Metab Res 2015; 47: 935-940
  • 23 Korah HE, Scholl UI. An update on familial hyperaldosteronism. Horm Metab Res. 2015; 47: 941–946
  • 24 Scholl UI, Stölting G, Nelson-Williams C, Vichot AA, Choi M, Loring E, Prasad ML, Goh G, Carling T, Juhlin CC, Quack I, Rump LC, Thiel A, Lande M, Frazier BG, Rasoulpour M, Bowlin DL, Sethna CB, Trachtman H, Fahlke C, Lifton RP. Recurrent gain of function mutation in calcium channel CACNA1H causes early-onset hypertension with primary aldosteronism. Elife 2015; 4: e06315
  • 25 Zennaro MC, Fernandes-Rosa F, Boulkroun S, Jeunemaitre X. Bilateral idiopathic adrenal hyperplasia: genetics and beyond. Horm Metab Res 2015; 47: 947-952
  • 26 Williams TA, Lenders JW, Burrello J, Beuschlein F, Reincke M. KCNJ5 mutations: sex, salt and selection. Horm Metab Res 2015; 47: 953-958
  • 27 Burrello J, Monticone S, Tetti M, Rossato D, Versace K, Castellano I, Williams TA, Veglio F, Mulatero P. Subtype diagnosis of primary aldosteronism: approach to different clinical scenarios. Horm Metab Res 2015; 47: 959-966
  • 28 Moors M, Williams TA, Deinum J, Eisenhofer G, Reincke M, Lenders JW. Steroid hormone production in patients with aldosterone producing adenomas. Horm Metab Res 2015; 47: 967-972
  • 29 Prejbisz A, Warchoł-Celińska E, Lenders JW, Januszewicz A. Cardiovascular risk in primary aldosteronism. Horm Metab Res 2015; 47: 973-980
  • 30 Catena C, Colussi G, Brosolo G, Novello M, Sechi LA. Aldosterone and left ventricular remodeling. Horm Metab Res 2015; 47: 981-986
  • 31 Remde H, Hanslik G, Rayes N, Quinkler M. Glucose metabolism in primary aldosteronism. Horm Metab Res 2015; 47: 987-993
  • 32 Asbach E, Bekeran M, Reincke M. Parathyroid gland function in primary aldosteronism. Horm Metab Res 2015; 47: 994-999
  • 33 Sechi LA, Colussi GL, Novello M, Uzzau A, Catena C. Mineralocorticoid receptor antagonists and clinical outcomes in primary aldosteronism: as good as surgery?. Horm Metab Res 2015; 47: 1000-1006