Management of hypertension in primary aldosteronism

查看全文 作　　者：Anna [1]Aronova;Thomas J Fahey Ⅲ[1];Rasa [1]Zarnegar

机构地区：[1]Department of Surgery, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY 10021, United States

出　　处：《World Journal of Cardiology》索引2014年第6卷第5期,共7页

摘　　要：Hypertension causes significant morbidity and mortal-ity worldwide, owing to its deleterious effects on the cardiovascular and renal systems. Primary hyperaldo-steronism(PA) is the most common cause of revers-ible hypertension, affecting 5%-18% of adults with hypertension. PA is estimated to result from bilateral adrenal hyperplasia in two-thirds of patients, and from unilateral aldosterone-secreting adenoma in approxi-mately one-third. Suspected cases are initially screened by measurement of the plasma aldosterone-renin-ratio, and may be confirmed by additional noninvasive tests. Localization of aldostosterone hypersecretion is then determined by computed tomography imaging, and in selective cases with adrenal vein sampling. Solitary adenomas are managed by laparoscopic or robotic re-section, while bilateral hyperplasia is treated with min-eralocorticoid antagonists. Biochemical cure following adrenalectomy occurs in 99% of patients, and hemo-dynamic improvement is seen in over 90%, prompting a reduction in quantity of anti-hypertensive medica-tions in most patients. End-organ damage secondary to hypertension and excess aldosterone is significantly improved by both surgical and medical treatment, asmanifested by decreased left ventricular hypertrophy, arterial stiffness, and proteinuria, highlighting the im-portance of proper diagnosis and treatment of primary hyperaldosteronism. Although numerous independent predictors of resolution of hypertension after adrenalec-tomy for unilateral adenomas have been described, the Aldosteronoma Resolution Score is a validated multifac-torial model convenient for use in daily clinical practice. 关键词：PRIMARY HYPERALDOSTERONISM HYPERTENSION ADRENALECTOMY ALDOSTERONOMA Treatment

相关文献

参考文献（38）
引证文献（11）
耦合文献（0）

参考文献(38)

引证文献(11)

互联网出版许可证新出网证(渝)字10号全国400电话 - 免长途话费

Management of hypertension in primary aldosteronism

参考文献(38)

引证文献(11)

用户提示