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Joshua E Raizman, Eleftherios P Diamandis, Daniel Holmes, Michael Stowasser, Richard Auchus, Etienne Cavalier, A Renin-ssance in Primary Aldosteronism Testing: Obstacles and Opportunities for Screening, Diagnosis, and Management, Clinical Chemistry, Volume 61, Issue 8, 1 August 2015, Pages 1022–1027, https://doi.org/10.1373/clinchem.2015.242990
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Primary aldosteronism (PA)9 is a group of adrenal disorders characterized by autonomous production of aldosterone independent of angiotensin II (AngII) stimulation. Idiopathic adrenal hyperplasia is the most common cause followed by aldosterone-producing adenomas (APA or Conn syndrome), unilateral adrenal hyperplasia, adrenal carcinoma, and rare familial forms. Aldosterone excess results in sodium and water retention and potassium excretion, leading to volume expansion, concomitant hypertension, and variable degrees of hypokalemia. As the most common form of secondary hypertension, PA is recognized as an important public health concern. The diagnosis is infrequently considered despite widely available screening procedures. In addition to the hypertension, the negative effects of excess aldosterone are thought to be related to inflammation and fibrosis of various target organs. As a result, patients with PA are at increased risk of cardiovascular and chronic kidney disease compared with age-matched and blood pressure–matched patients with essential hypertension. For these reasons early identification and treatment are necessary to prevent morbidity and mortality associated with this curable form of chronic hypertension.
