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    3698 results match your criteria Hyperaldosteronism Primary

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    Transarterial embolization of a hyperfunctioning aldosteronoma in a patient with bilateral adrenal nodules.
    Radiol Case Rep 2017 Mar 29;12(1):87-91. Epub 2016 Nov 29.
    Department of Vascular and Interventional Radiology, University of Miami Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136-1005, USA.
    Primary hyperaldosteronism often results in resistant hypertension and hypokalemia, which may lead to cardiovascular and cerebrovascular complications. Although surgery is first line treatment for unilateral functioning aldosteronomas, minimally invasive therapies may be first line for certain patients such as those who cannot tolerate surgery. We present a case of transarterial embolization (TAE) of an aldosteronoma. Read More

    NP-59 test for preoperative localization of primary hyperaldosteronism.
    Langenbecks Arch Surg 2017 Feb 21. Epub 2017 Feb 21.
    University Hospital La Princesa, Madrid, Spain.
    Purpose: Adrenal venous sampling is generally considered the gold standard to identify unilateral hormone production in cases of primary hyperaldosteronism. The aim of this study is to evaluate whether the iodine-131-6-β-iodomethyl-19-norcholesterol (NP-59) test may represent an alternative in selected cases.

    Methods: Patients submitted to laparoscopic adrenalectomy for suspected primary hyperaldosteronism (n = 27) were retrospectively reviewed. Read More

    Low dose-eplerenone treatment decreases aortic stiffness in patients with resistant hypertension.
    J Clin Hypertens (Greenwich) 2017 Feb 17. Epub 2017 Feb 17.
    Divisions of Nephrology and Intensive Care Medicine, Department of Internal Medicine, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
    Vascular damage is aggravated in animal models of hypertension with mineralocorticoid (MR) excess and in hypertensive patients with primary hyperaldosteronism. MR antagonism has shown to provide effective blood pressure (BP)-control in patients with treatment resistant hypertension (TRH), but the concurrent effects on the vasculature have not been examined. In a randomized, double-blinded, placebo-controlled parallel-group study, 51 patients with TRH received either eplerenone 50 mg or placebo for 6 months together with additional antihypertensives titrated to achieve a BP target of <140/90 mm Hg. Read More

    Anatomical Variations of the Right Adrenal Vein: Concordance Between Multidetector Computed Tomography and Catheter Venography.
    Hypertension 2017 Mar 30;69(3):428-434. Epub 2017 Jan 30.
    From the Department of Diagnostic Radiology (K.O., H.O., Y.T., T.M., K.S., K.T.), Department of Urology (Y.A.), and Division of Nephrology, Endocrinology, and Vascular Medicine (R.M., F.S.), Tohoku University Hospital, Sendai, Japan.
    Adrenal venous sampling is the most reliable diagnostic procedure to determine surgical indications in primary aldosteronism. Because guidelines recommend multidetector computed tomography (CT) to evaluate the adrenal gland, some past reports used multidetector CT as a guide for adrenal venous sampling. However, the detailed anatomy of the right adrenal vein and its relationship with an accessory hepatic vein remains uncertain. Read More

    Novel Approach to Establishing an Aldosterone: Renin Ratio Cutoff for Primary Aldosteronism.
    Hypertension 2017 Mar 9;69(3):450-456. Epub 2017 Jan 9.
    From the Division of Endocrinology and Metabolism, Department of Medicine (A.A.L., G.A.K.) and Calgary Laboratory Services, Department of Pathology and Laboratory Medicine, Section of Clinical Biochemistry (D.J.O., A.C., H.S.), University of Calgary, Alberta, Canada.
    Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. Read More

    Synthetic approaches towards the multi target drug spironolactone and its potent analogues/derivatives.
    Steroids 2017 Feb 29;118:76-92. Epub 2016 Dec 29.
    Department of Chemistry, Quaid-i-Azam University, 45320 Islamabad, Pakistan.
    Spironolactone is a well-known multi-target drug and is specifically used for the treatment of high blood pressure and heart failure. It is also used for the treatment of edema, cirrhosis of the liver, malignant, pediatric, nephrosis and primary hyperaldosteronism. Spironolactone in association with thiazide diuretics treats hypertension and in association with furosemide treats bronchopulmonary dyspepsia. Read More

    Improvement of Bone Turnover Markers and Bone Mineral Density following treatment of Primary Aldosteronism.
    Minerva Endocrinol 2016 Dec 20. Epub 2016 Dec 20.
    Endocrine Unit, Department of Medicine, University Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia -
    Background: Recent studies showed association between hyperaldosteronism and low bone density among patients with primary aldosteronism (PA) due to secondary hyperparathyroidism. Our objective is to assess bone turnover markers (BTM) and bone mineral density (BMD) of PA patients compared to essential hypertension.

    Methods: This was an open-label, prospective, case-controlled study, conducted over 12 months. Read More

    Histopathological classification of cross-sectional image negative hyperaldosteronism.
    J Clin Endocrinol Metab 2016 Dec 14:jc20162986. Epub 2016 Dec 14.
    1 Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan.
    Context: Approximately half of primary aldosteronism (PA) have clinically evident disease according to clinical (hypertension) and/or laboratory (aldosterone and renin levels) findings but do not have nodules detectable in routine cross-sectional imaging. However, the detailed histopathologic, steroidogenic and pathobiological features of cross-sectional image negative PA have not been well characterized.

    Objective: Examine histopathology, steroidogenic enzyme expression and somatic mutation status of aldosterone-driver genes in adrenals from cross-sectional image negative hyperaldosteronism. Read More

    Genetic characterization of a mouse line with primary aldosteronism.
    J Mol Endocrinol 2017 Feb 13;58(2):67-78. Epub 2016 Dec 13.
    Medizinische Klinik und Poliklinik IVEndocrine Research Unit, Klinikum der Universität München, LMU, Munich, Germany.
    In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism, a mutagenesis screen after treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. Read More

    A Novel Method of Adrenal Venous Sampling via an Antecubital Approach.
    Cardiovasc Intervent Radiol 2017 Mar 8;40(3):388-393. Epub 2016 Dec 8.
    Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China.
    Purpose: Currently, almost all adrenal venous sampling (AVS) procedures are performed by femoral vein access. The purpose of this study was to establish the technique of AVS via an antecubital approach and evaluate its safety and feasibility.

    Materials And Methods: From January 2012 to June 2015, 194 consecutive patients diagnosed as primary aldosteronism underwent AVS via an antecubital approach without ACTH simulation. Read More

    Plasma adrenocorticotropic hormone but not aldosterone is correlated with blood pressure in patients with aldosterone-producing adenomas.
    J Clin Hypertens (Greenwich) 2016 Dec 5. Epub 2016 Dec 5.
    Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
    Although plasma aldosterone concentration (PAC) varies depending on primary aldosteronism (PA) subtypes, patients with different subtypes may have similar blood pressure (BP). The authors hypothesized that hormones other than aldosterone might influence BP in PA patients. A total of 73 PA cases, including 30 cases of aldosterone-producing adenomas (APAs), 29 cases of bilateral hyperaldosteronism, and 24 control cases of essential hypertension were enrolled retrospectively. Read More

    Hypertension Cure Following Laparoscopic Adrenalectomy for Hyperaldosteronism is not Universal: Trends Over Two Decades.
    World J Surg 2016 Nov 21. Epub 2016 Nov 21.
    Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
    Background: Laparoscopic adrenalectomy has been established as a standard surgical method for unilateral primary aldosteronism. Meanwhile, the background characteristics of the patients undergoing adrenalectomy have changed over the last 20 years. The aim of this study was to investigate the changes in hypertension cure rates after laparoscopic adrenalectomy during the last two decades. Read More

    Preclinical and Early Clinical Profile of a Highly Selective and Potent Oral Inhibitor of Aldosterone Synthase (CYP11B2).
    Hypertension 2017 Jan 21;69(1):189-196. Epub 2016 Nov 21.
    From the Clinical Pharmacology (K.B., D.S., M.-L.D.), Biostatistics (G.P.), Discovery (K.A.), Pharmaceutical Sciences (S.M., M.C.D.V.M.), and Translational Medicine, Cardiovascular Diseases (P.F.), Pharma Research and Early Development, Roche Innovation Center Basel, Switzerland; and Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, United Kingdom (M.J.B).
    Primary hyperaldosteronism is a common cause of resistant hypertension. Aldosterone is produced in the adrenal by aldosterone synthase (AS, encoded by the gene CYP11B2). AS shares 93% homology to 11β-hydroxylase (encoded by the gene CYP11B1), responsible for cortisol production. Read More

    Scoring system for the diagnosis of bilateral primary aldosteronism in the outpatient setting before adrenal venous sampling.
    Clin Endocrinol (Oxf) 2016 Nov 8. Epub 2016 Nov 8.
    Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
    Objective: The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time-consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS. Read More

    Adrenal vein sampling in primary aldosteronism: concordance of simultaneous vs sequential sampling.
    Eur J Endocrinol 2017 Feb 11;176(2):159-167. Epub 2016 Nov 11.
    Department of RadiologyCentre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
    Objective: Many investigators believe that basal adrenal venous sampling (AVS) should be done simultaneously, whereas others opt for sequential AVS for simplicity and reduced cost. This study aimed to evaluate the concordance of sequential and simultaneous AVS methods.

    Design And Methods: Between 1989 and 2015, bilateral simultaneous sets of basal AVS were obtained twice within 5 min, in 188 consecutive patients (59 women and 129 men; mean age: 53. Read More

    Cardiac Dysfunction in Association with Increased Inflammatory Markers in Primary Aldosteronism.
    Endocrinol Metab (Seoul) 2016 Dec 3;31(4):567-576. Epub 2016 Nov 3.
    Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.
    Background: Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA.

    Methods: Thirty-two subjects (mean age, 50. Read More

    A Novel Phenotype of Familial Hyperaldosteronism Type III: Concurrence of Aldosteronism and Cushing's Syndrome.
    J Clin Endocrinol Metab 2016 Nov 12;101(11):4290-4297. Epub 2016 Jul 12.
    Department of Endocrinology (A.T., F.W.), Key Laboratory of Endocrinology, Ministry of Health, and Departments of Urology (G.L., Y.Z.) and Clinical Laboratory (D.Z.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; The Key Laboratory of Genome Sciences and Information (J.J.), Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100101, China; Department of Endocrinology (Z.Y.), Affiliated Hospital of the Inner Mongolia Medical University, Hohhot 010050, China; and Hypertension Center (J.C.), Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
    Context: To date, all the familial hyperaldosteronism type III (FH-III) patients reported presenting with typical primary aldosteronism (PA), without showing other adrenal hormone abnormalities.

    Objective: This study characterized a novel phenotype of FH-III and explored the possible pathogenesis.

    Patients And Methods: A male patient presented with severe hypertension and hypokalemia at the age of 2 years and developed Cushing's syndrome at 20 years. Read More

    Disordered zonal and cellular CYP11B2 enzyme expression in familial hyperaldosteronism type 3.
    Mol Cell Endocrinol 2017 Jan 25;439:74-80. Epub 2016 Oct 25.
    Division of Endocrinology, Henry Ford Health System, Detroit, MI, United States.
    Three forms of familial primary aldosteronism have been recognized. Familial Hyperaldosteronism type 1 (FH1) or dexamethasone suppressible hyperaldosteronism, FH2, the most common form of as yet unknown cause(s), and FH3. FH3 is due to activating mutations of the potassium channel gene KCNJ5 that increase constitutive and angiotensin II-induced aldosterone synthesis. Read More

    CACNA1H Mutations Are Associated With Different Forms of Primary Aldosteronism.
    EBioMedicine 2016 Nov 4;13:225-236. Epub 2016 Oct 4.
    INSERM, UMRS_970, Paris Cardiovascular Research Center, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France. Electronic address:
    Primary aldosteronism (PA) is the most common form of secondary hypertension. Mutations in KCNJ5, ATP1A1, ATP2B3 and CACNA1D are found in aldosterone producing adenoma (APA) and familial hyperaldosteronism (FH). A recurrent mutation in CACNA1H (coding for Cav3. Read More

    Transcriptome Pathway Analysis of Pathological and Physiological Aldosterone-Producing Human Tissues.
    Hypertension 2016 Dec 24;68(6):1424-1431. Epub 2016 Oct 24.
    From the Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom (J.Z., M.J.B.); Clinical Pharmacology Unit, Department of Medicine, University of Cambridge (J.Z.), University of Cambridge Metabolic Research Laboratories, Wellcome Trust MRC Institute of Metabolic Science (B.L., G.S.H.Y.), Cambridge University Hospitals NHS Foundation Trust (S.G.N.), Addenbrooke's Hospital, United Kingdom; and Department of Medicine, Faculty of Medicine, The National University of Malaysia (UKM) Medical Centre, Kuala Lumpur (E.A.B.A.).
    Primary aldosteronism is present in ≈10% of hypertensives. We previously performed a microarray assay on aldosterone-producing adenomas and their paired zona glomerulosa and fasciculata. Confirmation of top genes validated the study design and functional experiments of zona glomerulosa selective genes established the role of the encoded proteins in aldosterone regulation. Read More

    Primary Aldosteronism: Diagnosis and Management.
    Am J Med Sci 2016 Oct 1;352(4):391-398. Epub 2016 Jul 1.
    Department of Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee.
    Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Read More

    [Primary hyperaldosteronism due to unilateral adrenal hyperplasia with surgical resolution].
    Hipertens Riesgo Vasc 2016 Oct - Dec;33(4):155-158. Epub 2016 Apr 15.
    Servicio de Endocrinología y Nutrición, Hospital Universitario Doctor Peset, Valencia, España; Departamento de Medicina, Universidad de Valencia, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, España.
    Unilateral adrenal hyperplasia is a rare cause of primary hyperaldosteronism (around a 3%) that has surgical treatment. A case of a patient with hypertension resistant to conventional therapy in treatment with 7 drugs who presented with primary hyperaldosteronism due to unilateral adrenal hyperplasia is presented. A left adrenalectomy was performed, and the patient had a good clinical response, with no need of any drug after 2 years of surgery. Read More

    Risk factors for renal impairment revealed after unilateral adrenalectomy in patients with primary aldosteronism.
    Medicine (Baltimore) 2016 Jul;95(27):e3930
    aDepartment of Medicine, Division of Nephrology bBiostatistics and Clinical Epidemiology Center cDepartment of Surgery dDepartment of Medicine, Division of Endocrinology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. Read More

    OS 35-09 LONG-TERM OUTCOME OF SURGICALLY- AND MEDICALLY-TREATED PATIENTS OF THE PRIMARY ALDOSTERONISM PREVALENCE IN HYPERTENSIVES (PAPY) STUDY.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e401
    Department of Medicine, University of Padova, Italy.
    Objective: PA causes excess cardiovascular (CV) damage, but whether it worsens prognosis remained uncertain as there are no prospective studies. To compare long-term outcome of the 1125 patients recruited in the PAPY study.

    Design And Method: 11. Read More

    SY 14-3 PRIMARY ALDOSTERONISM IN RESISTANT HYPERTENSION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e369
    University of Alabama at Birmingham, U.S.A.
    : Resistant hypertension refers to patients with difficult-to-treat hypertension, generally defined as needing three or more medications of different classes, including, if tolerated, a diuretic. Observational studies indicate that the prevalence of resistant hypertension based on the preceding definition of needing 3 or medications for blood pressure (BP) control is approximately 15-20% of patients being treated for hypertension. However, causes of pseudoresistance are common, including poor BP technique, poor adherence, white coat effects, and under-treatment, all of which must be identified in order to distinguish apparent resistance from true treatment resistance. Read More

    BR 04-1MANAGEMENT OF TREATMENT-RESISTANT HYPERTENSION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e198
    University of Edinburgh, United Kingdom.
    Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Read More

    HW 01-3 CARDIAC AND VASCULAR MRI IN HYPERTENSION EVALUATION.
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e27
    Samsung Medical Center, Korea, Republic of.
    Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension. Read More

    SY 03-3 OVERVIEW OF SOMATIC MUTATIONS AND EPIGENETIC REGULATION OF ALDOSTERONE PRODUCING ADENOMA (APA).
    J Hypertens 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e14-e15
    Yokohama City University Graduate School of Medicine, Japan.
    Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA. Read More

    Variant Discovery and Fine Mapping of Genetic Loci Associated with Blood Pressure Traits in Hispanics and African Americans.
    PLoS One 2016 13;11(10):e0164132. Epub 2016 Oct 13.
    Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
    Despite the substantial burden of hypertension in US minority populations, few genetic studies of blood pressure have been conducted in Hispanics and African Americans, and it is unclear whether many of the established loci identified in European-descent populations contribute to blood pressure variation in non-European descent populations. Using the Metabochip array, we sought to characterize the genetic architecture of previously identified blood pressure loci, and identify novel cardiometabolic variants related to systolic and diastolic blood pressure in a multi-ethnic US population including Hispanics (n = 19,706) and African Americans (n = 18,744). Several known blood pressure loci replicated in African Americans and Hispanics. Read More

    ACTH stimulation test and computed tomography are useful for differentiating the subtype of primary aldosteronism.
    Endocr J 2017 Jan 1;64(1):65-73. Epub 2016 Oct 1.
    Department of Endocrinology, Diabetes and Metabolism, Graduate School of Medicine, Nippon Medical School, Tokyo 113-8603, Japan.
    The diagnostic steps for primary aldosteronism (PA) include case screening tests, confirmatory tests, and localization. The aim of this study was to identify useful confirmatory tests and their cut-off values for differentiating the subtype of primary aldosteronism, especially in unilateral PA, such as aldosterone-producing adenoma, and bilateral PA, such as idiopathic hyperaldosteronism. Seventy-six patients who underwent all four confirmatory tests, the captopril-challenge test (CCT), furosemide upright test (FUT), saline infusion test (SIT), and ACTH stimulation test (AST), and who were confirmed to have an aldosterone excess by adrenal venous sampling (AVS) were recruited. Read More

    Comparison between adrenal venous sampling and computed tomography in the diagnosis of primary aldosteronism and in the guidance of adrenalectomy.
    Medicine (Baltimore) 2016 Sep;95(39):e4986
    aDepartment of Hypertension bDepartment of Radiology cDepartment of Urology of Luwan Branch dDepartment of Urology eShanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
    In our series of patients with primary aldosteronism, we compared diagnostic concordance and clinical outcomes after adrenalectomy between adrenal venous sampling (AVS) and computed tomography (CT) imaging.Our retrospective analysis included 886 patients with primary aldosteronism diagnosed in our hospital between 2005 and 2014. Of them, 269 patients with CT unilateral adrenal disease were included in the analysis on the diagnostic concordance and 126 patients with follow-up data in the analysis on clinical outcomes after adrenalectomy. Read More

    Evaluation of insulin sensitivity and secretion in primary aldosteronism.
    Clin Exp Hypertens 2016;38(7):613-617. Epub 2016 Sep 26.
    a Department of Endocrinology and Hypertension , Tokyo Women's Medical University , Tokyo , Japan.
    In primary aldosteronism (PA), insulin response to glucose is not fully understood. Insulin action was elucidated using indices in 32 PA and 21 essential hypertension (EH) patients. These patients were evaluated using homeostasis model assessment (HOMA) indices, quantitative insulin sensitivity check index (QUICKI), and insulinogenic index (IGI), which were expressed for insulin sensitivity/secretion and the early phase of insulin secretion. Read More

    Primary aldosteronism in patients with acute stroke: prevalence and diagnosis during initial hospitalization.
    BMC Neurol 2016 Sep 17;16:177. Epub 2016 Sep 17.
    Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
    Background: Hypertension is the prime risk factor for stroke, and primary aldosteronism (PA) is the most common cause of secondary hypertension. The prevalence of PA in stroke patients has never been reported. The aim of this study was to elucidate the prevalence of PA. Read More

    Use of Aldosterone Antagonists for Treatment of Uncontrolled Resistant Hypertension.
    Am J Hypertens 2017 Feb 8;30(2):103-109. Epub 2016 Sep 8.
    Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Alabama, USA.
    Background: Multiple studies indicate that primary aldosteronism (PA) is common in patients with resistant hypertension, with an estimated prevalence of approximately 20%. Additional studies suggest that beyond this 20% of patients with classical PA, there is a larger proportion of patients with lesser degrees of hyperaldosteronism which contributes even more broadly to antihypertensive treatment resistance. Given these observations, it is intuitive that use of aldosterone antagonists will provide antihypertensive benefit in patients with resistant hypertension and evidence of aldosterone excess. Read More

    Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism.
    Hypertension 2016 Oct 6;68(4):989-94. Epub 2016 Sep 6.
    From the Université Paris-Descartes, Faculty of Medicine, Paris, France (E.K., S.B., F.Z., P.-F.P., L.A.); Assistance Publique-Hôpitaux de Paris (AP-HP), Hypertension Unit (E.C., E.K., P.-F.P., L.A.), Interventional Radiology (J.-Y.P.), Radiology (C.G.), Physiology Department (S.B.), Surgery (F.Z.), Georges Pompidou European Hospital, Paris, France; AP-HP, Internal Medicine Department, Tenon Hospital, Paris, France (O.S.); Faculty of Medicine, Université Pierre et Marie Curie-Paris 6, Paris, France (O.S.); Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 970 Equipe 14 (P.-F.P., L.A.) and UMR_S1142 (O.S.), Paris, France; and Department of Internal Medicine, Centro Hospitalar São João, Porto, Portugal Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Portugal (L.N.).
    Guidelines recommend suppression tests such as the saline infusion test (SIT) to ascertain the diagnosis of primary aldosteronism (PA) in patients with a high aldosterone:renin ratio. However, suppression tests have only been evaluated in small retrospective series, and some experts consider that they are not helpful for the diagnosis of PA. In this study, we evaluated whether low post-SIT aldosterone concentrations do exclude lateralized PA. Read More

    Determination of urinary aldosterone using a plasma aldosterone 2D ID LC-MS/MS method.
    Bioanalysis 2016 Sep 5;8(17):1765-75. Epub 2016 Aug 5.
    Department of Clinical Chemistry, Laboratory of Endocrinology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
    Aim: In the diagnosis for primary aldosteronism, the measurement of urinary aldosterone is part of the confirmation test but diagnostic accuracy may be blunted due to poor immunoassay performance for urinary aldosterone. Nowadays, plasma aldosterone concentrations are measured preferably by LC-MS/MS yet such methods for urinary aldosterone are lacking.

    Methods & Results: We show that plasma and urinary aldosterone can be measured with the same 2D isotope dilution LC-MS/MS method. Read More

    Genetics of primary hyperaldosteronism.
    Endocr Relat Cancer 2016 Oct 2;23(10):R437-54. Epub 2016 Aug 2.
    Department of SurgeryCounty Council of Östergötland, Department of Clinical and Experimental Medicine, Medical Faculty, Linköping University, Linköping, Sweden
    Hypertension is a common medical condition and affects approximately 20% of the population in developed countries. Primary aldosteronism is the most common form of secondary hypertension and affects 8-13% of patients with hypertension. The two most common causes of primary aldosteronism are aldosterone-producing adenoma and bilateral adrenal hyperplasia. Read More

    Mouse Models Recapitulating Human Adrenocortical Tumors: What Is Lacking?
    Front Endocrinol (Lausanne) 2016 15;7:93. Epub 2016 Jul 15.
    UMR6293, GReD, INSERM U1103, CNRS, Clermont Université , Clermont-Ferrand , France.
    Adrenal cortex tumors are divided into benign forms, such as primary hyperplasias and adrenocortical adenomas (ACAs), and malignant forms or adrenocortical carcinomas (ACCs). Primary hyperplasias are rare causes of adrenocorticotropin hormone-independent hypercortisolism. ACAs are the most common type of adrenal gland tumors and they are rarely "functional," i. Read More

    Severe hyperkalemia following adrenalectomy for aldosteronoma: prediction, pathogenesis and approach to clinical management- a case series.
    BMC Endocr Disord 2016 Jul 27;16(1):43. Epub 2016 Jul 27.
    Department of Endocrinology, Cummings School of Medicine- University of Calgary, Alberta, Canada.
    Background: As the field of Primary Aldosteronism (PA) becomes ever expanded, diagnosis of PA is increasingly diagnosed by endocrinologists. With increased PA screening, many of the cases are now found in patients with complex co-morbidities in addition to their hypertension. Post adrenalectomy renal impairment with hyperkalemia is now increasingly seen in these complex patients, as evidenced by the numerous reports on this issue that have appeared within the past 3 years. Read More

    Hyperaldosteronism and cardiovascular risk in patients with autosomal dominant polycystic kidney disease.
    Medicine (Baltimore) 2016 Jul;95(29):e4175
    aDepartment of Clinical Medicine, Sapienza University of Rome, Rome bDepartment of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome cCobellis Clinic, Tirreno SRL, Vallo della lucania, Sapri, Salerno dDepartment of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome eDepartment of Clinical and Experimental Sciences, University of Brescia, Brescia fDepartment of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy.
    Hypertension is commonly associated with autosomal dominant polycystic kidney disease (ADPKD), often discovered before the onset of renal failure, albeit the pathogenetic mechanisms are not well elucidated. Hyperaldosteronism in ADPKD may contribute to the development of insulin resistance and endothelial dysfunction, and progression of cardiorenal disease. The aim of study was to evaluate the prevalence of primary aldosteronism (PA) in ADPKD patients and identify some surrogate biomarkers of cardiovascular risk. Read More

    Small-Conductance Ca2+-Activated Potassium Channels Negatively Regulate Aldosterone Secretion in Human Adrenocortical Cells.
    Hypertension 2016 Sep 18;68(3):785-95. Epub 2016 Jul 18.
    From the Department of Physiology and Biophysics, School of Life Sciences, Institutes of Brain Science (T.Y., Q.L., Y.-A.M., C.H.) and Department of Oncology, Shanghai Medical College (H.-L.Z.), Fudan University, China; Department of Urology, Fudan University Shanghai Cancer Center, China (H.-L.Z.); and Department of Pharmacology, University of Virginia, Charlottesville (Y.S., P.Q.B.).
    Aldosterone, which plays a key role in maintaining water and electrolyte balance, is produced by zona glomerulosa cells of the adrenal cortex. Autonomous overproduction of aldosterone from zona glomerulosa cells causes primary hyperaldosteronism. Recent clinical studies have highlighted the pathological role of the KCNJ5 potassium channel in primary hyperaldosteronism. Read More

    Primary hyperaldosteronism: a case of unilateral adrenal hyperplasia with contralateral incidentaloma.
    BMJ Case Rep 2016 Jul 14;2016. Epub 2016 Jul 14.
    Department of Medicine, Buffalo, New York, USA.
    Primary hyperaldosteronism is one of the most common causes of secondary hypertension but clear differentiation between its various subtypes can be a clinical challenge. We report the case of a 37-year-old African-American woman with refractory hypertension who was admitted to our hospital for palpitations, shortness of breath and headache. Her laboratory results showed hypokalaemia and an elevated aldosterone/renin ratio. Read More

    Risk factors for renal impairment revealed after unilateral adrenalectomy in patients with primary aldosteronism.
    Medicine (Baltimore) 2016 Jul;95(27):e3930
    aDepartment of Medicine, Division of Nephrology bBiostatistics and Clinical Epidemiology Center cDepartment of Surgery dDepartment of Medicine, Division of Endocrinology, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. Read More

    Central serous chorioretinopathy in primary hyperaldosteronism.
    Graefes Arch Clin Exp Ophthalmol 2016 Oct 8;254(10):2033-2042. Epub 2016 Jul 8.
    Department of Ophthalmology, Leiden University Medical Center, Department J3-S, PO Box 9600, 2300RC, Leiden, Netherlands.
    Purpose: To describe ophthalmological characteristics of 13 patients with primary hyperaldosteronism (PA).

    Methods: Cross-sectional study. All patients underwent extensive ophthalmological examination. Read More

    A case report of malignant hypertension in a young woman.
    BMC Nephrol 2016 Jul 7;17(1):65. Epub 2016 Jul 7.
    Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, Trieste, Italy.
    Background: Malignant hypertension is a condition characterized by severe hypertension and multi-organ ischemic complications. Albeit mortality and renal survival have improved with antihypertensive therapy, progression to end-stage renal disease remains a significant cause of morbidity and mortality. The underlying cause of malignant hypertension, which can be primary or secondary hypertension, is often difficult to identify and this can substantially affect the treatment outcomes, as we report here. Read More

    Adrenal vein sampling versus CT scan to determine treatment in primary aldosteronism: an outcome-based randomised diagnostic trial.
    Lancet Diabetes Endocrinol 2016 Sep 17;4(9):739-46. Epub 2016 Jun 17.
    Department of Internal Medicine, Division of Vascular Medicine, Radboud University Medical Center, Nijmegen, Netherlands. Electronic address:
    Background: The distinction between unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia as causes of primary aldosteronism is usually made by adrenal CT or by adrenal vein sampling (AVS). Whether CT or AVS represents the best test for diagnosis remains unknown. We aimed to compare the outcome of CT-based management with AVS-based management for patients with primary aldosteronism. Read More

    SFE/SFHTA/AFCE consensus on primary aldosteronism, part 3: Confirmatory testing.
    Ann Endocrinol (Paris) 2016 Jul 16;77(3):202-7. Epub 2016 Jun 16.
    Service d'endocrinologie, hôpital Haut-Lévêque, CHU de Bordeaux, avenue de Magellan, 33600 Pessac, France.
    Aldosterone/renin ratio (ARR) identifies patients at high or low risk of primary aldosteronism (PA), but sensitivity and especially specificity are suboptimal and confirmatory testing may therefore be necessary, in some but not all patients. In patients with elevated ARR and plasma aldosterone concentration above 550pmol/L (20ng/dL) on two assessments, PA can be diagnosed without confirmatory testing. Conversely, PA can be ruled out without confirmatory testing in patients with normal ARR and plasma aldosterone concentration below 240pmol/L (9ng/dL) on two assessments. Read More

    SFE/SFHTA/AFCE consensus on primary aldosteronism, part 7: Medical treatment of primary aldosteronism.
    Ann Endocrinol (Paris) 2016 Jul 14;77(3):226-34. Epub 2016 Jun 14.
    Service d'endocrinologie, diabète et maladies métaboliques, centre hospitalier universitaire, 76031 Rouen, France. Electronic address:
    Spironolactone, which is a potent mineralocorticoid receptor antagonist, represents the first line medical treatment of primary aldosteronism (PA). As spironolactone is also an antagonist of the androgen and progesterone receptor, it may present side effects, especially in male patients. In case of intolerance to spironolactone, amiloride may be used to control hypokaliemia and we suggest that eplerenone, which is a more selective but less powerful antagonist of the mineralocorticoid receptor, be used in case of intolerance to spironolactone and insufficient control of hypertension by amiloride. Read More

    SFE/SFHTA/AFCE consensus on primary aldosteronism, part 5: Genetic diagnosis of primary aldosteronism.
    Ann Endocrinol (Paris) 2016 Jul 15;77(3):214-9. Epub 2016 Jun 15.
    INSERM, U970, Paris Cardiovascular Research Center-PARCC, 56, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Service de génétique, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, Paris, France.
    While the majority of cases of primary aldosteronism (PA) are sporadic, four forms of autosomal-dominant inheritance have been described: familial hyperaldosteronism (FH) types I to IV. FH-I, also called glucocorticoid-remediable aldosteronism, is characterized by early and severe hypertension, usually before the age of 20 years. It is due to the formation of a chimeric gene between the adjacent CYP11B2 and CYP11B1 genes (coding for aldosterone synthase and 11β-hydroxylase, respectively). Read More

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