Search Our Scientific Publications & Authors

J Clin Endocrinol Metab 2019 Mar 13. Epub 2019 Mar 13.

Hypertension Unit, Department of Medicine -DIMED, University of Medicine of Padova, Padova, Italy.

Context: Accumulating evidences suggest a link between adrenocortical zona glomerulosa and parathyroid gland through mechanisms that remain unexplored.

Objectives: To test the hypothesis that in vivo Angiotensin (Ang) II blockade affects parathyroid hormone (PTH) secretion in hypertensive patients and that aldosterone and Ang II directly stimulate PTH secretion ex vivo.

Design And Setting: We investigated the changes of serum PTH levels induced by oral captopril (50 mg) administration in patients with primary essential hypertension (EH) and with primary aldosteronism (PA) due to bilateral adrenal hyperplasia (BAH) or to aldosterone-producing adenoma (APA), the latter before and after adrenalectomy. Read More

Clin Endocrinol (Oxf) 2019 Feb 28. Epub 2019 Feb 28.

Shanghai Key Laboratory for Endocrine Tumors, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of Chinese Health Ministry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, P.R.

Context: Adrenal venous sampling (AVS) is recommended as the gold standard for subtype classification in primary aldosteronism (PA); however, this approach has limited availability.

Objective: We aimed to develop a novel clinical nomogram to predict PA subtype based on routine variables, thereby reducing the number of candidates for AVS.

Patients And Method: Patients were randomly divided into a training set (n=185) and a validation set (n=79). Read More

Biochemistry 2019 Mar 14. Epub 2019 Mar 14.

Department of Cell Physiology and Molecular Biophysics, Center for Membrane Protein Research , Texas Tech University Health Sciences Center , Lubbock , Texas 79430 , United States.

Primary hyperaldosteronism (Conn's syndrome), a common cause of secondary hypertension, is frequently produced by unilateral aldosterone-producing adenomas that carry mutations in ion-transporting genes, including ATP1A1, encoding the Na/K pump's α1 subunit. Whether Na/K pump mutant-mediated inward currents are required to depolarize the cell and increase aldosterone production remains unclear, as such currents were observed in four out of five mutants described so far. Here, we use electrophysiology and uptake of the K congener Rb, to characterize the effects of eight additional Na/K pump mutations in transmembrane segments TM1 (delM102-L103, delL103-L104, and delM102-I106), TM4 (delI322-I325 and I327S), and TM9 (delF956-E961, delF959-E961, and delE960-L964), expressed in Xenopus oocytes. Read More

Am J Hypertens 2019 Feb 11. Epub 2019 Feb 11.

Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, United Kingdom.

Background: Activation of beta-1 adrenoreceptors (β1-AR) in the kidney releases renin that plays a major role in the maintenance of blood pressure. Genetic variation in the β1-AR could therefore alter the physiological and clinical effects of this hormone. We tested this hypothesis in patients from a primary care cohort being screened for primary hyperaldosteronism, PHA (n=465). Read More

Hypertension 2019 Apr;73(4):885-892

From the Department of Molecular and Integrative Physiology (K.N., W.E.R.), University of Michigan, Ann Arbor.

Somatic mutations have been identified in aldosterone-producing adenomas (APAs) in genes that include KCNJ5, ATP1A1, ATP2B3, and CACNA1D. Based on independent studies, there appears to be racial differences in the prevalence of somatic KCNJ5 mutations, particularly between East Asians and Europeans. Despite the high cardiovascular disease mortality of blacks, there have been no studies focusing on somatic mutations in APAs in this population. Read More

Internist (Berl) 2019 Feb 1. Epub 2019 Feb 1.

Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Primary aldosteronism (PA) is a frequent cause of resistant hypertension. The clinical presentation is heterogeneous, but a suppressed or low normal renin (especially with ACE inhibitors or sartans) should raise suspicion for primary aldosteronism, even when aldosterone levels are in the normal range. Diagnosis of unilateral hormone production from an adrenal adenoma (Conn syndrome), which is curable by surgery, requires adrenal vein sampling, which should be performed in experienced centers. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018 ;118(12):49-52

Federal Research Centre of Nutrition and Biotechnology.

Germline mutations in CACNA1D cause the primary aldosteronism, seizures, and neurologic abnormalities (PASNA) syndrome (OMIM# 615474) characterized by primary aldosteronism, seizures and neurological abnormalities. The authors present a case-report of a 1-year 3-month male patient with neurological symptoms such as seizures and global developmental delay with primary hyperaldosteronism. The heterozygosis disease-causing variant c. Read More

J Labelled Comp Radiopharm 2019 Jan 28. Epub 2019 Jan 28.

Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.

[ C]metomidate ([ C]MTO) is a radiotracer widely used to detect disorders of adrenocortical origin by positron emission tomography (PET) imaging. [ C]MTO PET/computed tomography (PET/CT) is considered a sensitive and specific noninvasive alternative to adrenal vein sampling (AVS) in the management of primary hyperaldosteronism (PHA). Herein, we report a reliable automated procedure for the routine manufacturing of [ C]MTO in current good manufacturing practice (cGMP) conditions on the commercial Synthra MeI Loop Vessel synthesizer. Read More

Vitam Horm 2019 23;109:285-302. Epub 2018 Dec 23.

Hudson Institute of Medical Research, Clayton, VIC, Australia; Monash University, Clayton, VIC, Australia. Electronic address:

Primary aldosteronism (PA), currently recognized to be 5-10% of hypertension, has a cardiovascular risk profile double that in age-, sex-, and blood pressure-matched essential hypertensives. Screening for PA is by determining the plasma aldosterone to renin ratio (ARR), followed by one of half a dozen confirmatory/exclusion tests. Unilateral hyperaldosteronism normally reflects an aldosterone producing adenoma; bilateral disease is the more common form, and termed idiopathic hyperaldosteronism (IHA). Read More

J Coll Physicians Surg Pak 2019 Jan;29(1):58-61

Department of Medicine, Military Hospital, Rawalpindi, Pakistan.

Objective: To determine the frequency of primary hyperaldosteronism in young hypertensives in hospital settings of Rawalpindi.

Study Design: Cross-sectional study.

Place And Duration Of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from June 2016 to May 2017. Read More

Hypertens Res 2019 Jan 8. Epub 2019 Jan 8.

Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Adrenal venous sampling (AVS) is the gold standard test for distinguishing between unilateral and bilateral primary aldosteronism (PA); however, AVS requires advanced and time consuming technique. The needs for AVS have been increasing due to the increased utilization of screening for PA. An efficient selection of unilateral PA, such as aldosterone-producing adenoma (APA), before AVS is useful to avoid undesirable AVS in bilateral PA, such as idiopathic hyperaldosteronism. Read More

Curr Opin Nephrol Hypertens 2019 Mar;28(2):105-112

Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan.

Purpose Of Review: Immunohistochemistry for aldosterone synthase (CYP11B2) has markedly provided a comprehensive picture of the adrenocortical diseases, particularly primary aldosteronism. The findings from CYP11B2-immunohistochemistry are consistent with the clinical courses of most patients with primary aldosteronism. We herein review the updated pathophysiology and usefulness of the method for understanding individual patients with different subtypes of primary aldosteronism. Read More

Hypertension 2019 Feb;73(2):469-480

From the Biozentrum, University of Basel, Switzerland (M.M.S., M.C., E.D., P.J., S.M., C.P., M.N.H.), University Hospital Basel, Switzerland.

Primary aldosteronism is a disease of excessive production of adrenal steroid hormones and the most common cause of endocrine hypertension. Primary aldosteronism results mainly from bilateral adrenal hyperplasia or unilateral aldosterone-producing adenoma (APA). Primary aldosteronism cause at the molecular level is incompletely understood and a targeted treatment preventing excessive adrenal steroid production is not available. Read More

Hypertension 2019 Feb;73(2):407-414

From the Department of Pharmacology (N.A.G., J.Y., E.J.S., D.A.B, P.Q.B.), University of Virginia School of Medicine, Charlottesville.

The renin-angiotensin system tightly controls aldosterone synthesis. Dysregulation is evident in hypertension (primary aldosteronism), low renin, and resistant hypertension) but also can exist in normotension. Whether chronic, mild aldosterone autonomy can elicit hypertension remains untested. Read More

Clin Endocrinol (Oxf) 2019 Apr 25;90(4):528-533. Epub 2019 Jan 25.

Department of Endocrinology, The Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.

Introduction: The aldosterone/renin ratio is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.

Methods: Following clinical observation of a high prevalence of abnormal aldosterone/renin ratio (ARR) in patients of African-origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaemia, intraventricular septal thickness (IVS, by echocardiography) and adrenal imaging were recorded when available. Read More

Rev Endocr Metab Disord 2018 Dec 19. Epub 2018 Dec 19.

Department of Pediatrics, Hospital Lluís Alcanyís de Xàtiva, Ctra. Xàtiva a Silla km 2, 46800, Xàtiva, Valencia, Spain.

Less than 15% of hypertension cases in children are secondary to a primary hyperaldosteronism. This is idiopathic in 60% of the cases, secondary to a unilateral adenoma in 30% and 10% remaining by primary adrenal hyperplasia, familial hyperaldosteronism, ectopic aldosterone production or adrenocortical carcinoma.To date, four types of familial hyperaldosteronism (FH I to FH IV) have been reported. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13608

Department of Cardiology, the First Hospital of Jilin University, Changchun, Jilin Province, China.

Rationale: Primary aldosteronism (PA) with hypokalemia increases the risk of life-threatening ventricular arrhythmias. Cases of PA with malignant arrhythmia as the first symptom have been reported. The role of severe hypokalemia in triggering malignant ventricular arrhythmia is well documented. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13591

Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital, Gulou District, Nanjing City, Jiangsu Province, PR China.

Rationale: Primary aldosteronism due to aldosteronoma is the most common form of secondary hypertension, with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Diagnosis is a clinical challenge with simultaneous occurrence of primary ectopic meningioma in the adrenal gland. To our knowledge this is the first reported case of simultaneous occurrence of aldosteronomas and ectopic meningioma in the adrenal gland based on literatures. Read More

Am J Physiol Regul Integr Comp Physiol 2019 Feb 6;316(2):R157-R164. Epub 2018 Dec 6.

Oregon Institute of Occupational Health Sciences, Oregon Health & Science University , Portland, Oregon.

Measurements of aldosterone for diagnosis of primary aldosteronism are usually made from blood sampled in the morning when aldosterone typically peaks. We tested the relative contributions and interacting influences of the circadian system, ongoing behaviors, and prior sleep to this morning peak in aldosterone. To determine circadian rhythmicity and separate effects of behaviors on aldosterone, 16 healthy participants completed a 5-day protocol in dim light while all behaviors ranging from sleep to exercise were standardized and scheduled evenly across the 24-h circadian period. Read More

Endocrinol Metab (Seoul) 2018 Dec;33(4):485-492

Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Read More

Minerva Endocrinol 2018 Nov 26. Epub 2018 Nov 26.

Clinical Academic Unit, Newcastle University Medicine Malaysia, Johor, Malaysia.

Background: Recent studies showed a possible association between hyperaldosteronism and secondary hyperparathyroidism leading to reduced bone health, however results are conflicting.

Methods: We conducted a meta-analysis to evaluate the relationship between primary aldosteronism (PA) with bone biochemical markers and to assess bone mineral density in patients with primary aldosteronism.

Results: A total of 939 subjects were examined (37. Read More

Eur J Endocrinol 2019 Feb;180(2):R45-R58

Department of Endocrinology and Diabetology, Côte de Nacre Regional Hospital Center, Caen, France.

The strategy for diagnosis of primary aldosteronism (PA) in the hypertensive population includes firstly a screening step, based on the measurement of plasma aldosterone-to-renin ratio (ARR), a test which must have high sensitivity, and secondly a confirmatory step based on the demonstration of excessive aldosterone production independent of the renin-angiotensin-aldosterone system (RAAS) activity. The high proportion of false-positive ARR results and conversely of actual PA without a persistent elevation in baseline plasma aldosterone concentration necessitates the addition of a confirmatory step in the work-up of PA diagnosis. The present review focuses on the description of the different dynamic tests available for demonstrating autonomy of aldosterone secretion, on the performance and limitations of confirmatory tests and on possible strategies for PA diagnosis which may either include or avoid the confirmatory step for PA diagnosis. Read More

Endocr Relat Cancer 2018 Nov 1. Epub 2018 Nov 1.

T Else, Metabolism, Endocrinology and Diabetes/Internal Medicine, University of Michigan, Ann Arbor, United States.

Several somatic mutations specific to aldosterone-producing adenomas (APA) have been described. A small proportion of adrenocortical carcinomas (ACC) are associated with hyperaldosteronism, either primary aldosteronism or hyperreninemic hyperaldosteronism. However, it is unknown, whether they harbor mutations of the same spectrum as APAs. Read More

Surgery 2019 Mar 23;165(3):622-628. Epub 2018 Nov 23.

Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan. Electronic address:

Background: An elevated plasma aldosterone level has been reported as an independent risk factor for severe erectile dysfunction in men. The aim of this study was to explore whether primary hyperaldosteronism patients experience erectile dysfunction after targeted treatment.

Methods: We conducted a population-based cohort study of men with newly identified primary hyperaldosteronism/aldosterone-producing adenoma from January 1, 1997, to December 31, 2009. Read More

Crit Care 2018 11 21;22(1):313. Epub 2018 Nov 21.

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Background: The interaction between hyperaldosteronism and immune dysfunction has been reported and glucocorticoid co-secretion is frequently found in primary aldosteronism (PA). The aforementioned conditions raise the possibility of the infection risk; however, clinical episodes of sepsis have not been reported in PA.

Methods: Using Taiwan's National Health Insurance Research Database between 1997 and 2009, we identified PA and aldosterone-producing adenoma (APA) matched with essential hypertension (EH) at a 1:1 ratio by propensity scores. Read More

Am J Hypertens 2019 Jan;32(2):155-162

The Shanghai Institute of Hypertension, Department of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Background: Primary aldosteronism (PA) may cause myocardial injury. We investigated myocardial dysfunction using speckle-tracking echocardiographic (STE) layer-specific strain in patients with PA.

Methods: Our study included 62 patients with PA (33 aldosterone-producing adenoma [APA] and 29 idiopathic hyperaldosteronism [IHA]) and 30 patients with primary hypertension. Read More

Medicine (Baltimore) 2018 Nov;97(47):e13268

Pathology Department, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, Hainan, PR China.

Rationale: Paraganglioma is a catecholamine-producing neuroendocrine tumor. Management of paraganglioma including its diagnosis is difficult, because it has no characteristic symptoms and many diseases can manifest as headache and high blood pressure. Herein, we report a rare case of paraganglioma of the abdomen with headache and initial normal blood pressure. Read More

Vnitr Lek 2018 ;64(7-8):815-820

Spironolactone, a mineralocorticoid receptor antagonist, is used in the treatment of hypertension for over 50 years. Due to the absence of morbidity and mortality studies, it is not considered to be a first-choice drug in the treatment of patients with primary hyperaldosteronism. However, it has a secure and stable position in the treatment of resistant hypertension. Read More

J Hypertens 2019 Mar;37(3):603-611

Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan.

: Nowadays most patients diagnosed with surgically curable primary aldosteronism have small or micro aldosterone-producing adenoma or unilateral micronodular hyperplasia, which are undetectable with available imaging technologies. Therefore, a negative imaging test by no means excludes unilateral primary aldosteronism. Moreover, about 10% of the subjects above the age of 35 years have nonfunctioning adrenal tumors, regardless of being hypertensive or not, with a prevalence that raises with aging. Read More

Tunis Med 2018 May;96(5):326-328

Tunis Med 2018 Jul;96(7):454-457

Although initially considered a rarity, primary aldosteronism now is one of the more common causes of secondary hypertension. Based on older data, it was originally estimated that primary aldosteronism accounted for less than 1% of all patients with hypertension. Subsequent data, however, indicated that it may actually occur in as many as 5-15% of patients with hypertension. Read More

MMW Fortschr Med 2018 11;160(Suppl 3):54-58

Medizinische Klinik und Polklinik IV, Klinikum der Universität München, Ziemssenstrasse 1, D-80336, München, Deutschland.

J Hypertens 2018 Nov 9. Epub 2018 Nov 9.

Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine.

Objective: Primary aldosteronism is one of the most common cause of secondary hypertension. It is well known that the incidence of cardiovascular events is higher in patients with primary aldosteronism than in patients with essential hypertension. In a previous study, we showed that aldosterone-producing adenoma is associated with vascular function and structure. Read More

High Blood Press Cardiovasc Prev 2018 Dec 10;25(4):345-354. Epub 2018 Nov 10.

Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Via Ospedale Civile, 105, 35128, Padova, Italy.

Prevalence of arterial hypertension is up to 30-40% in epidemiological studies, it increases with aging and affects the cardiovascular risk. Essential form of hypertension is the most frequent; however, 5-10% of patients are affected by a specific and potentially reversible cause of increased blood pressure levels, called secondary hypertension. In general, all patients with young onset-age (< 40-50 years) or resistant hypertension should be screened for secondary forms. Read More

Clin Hypertens 2018 1;24:15. Epub 2018 Nov 1.

Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586 Kuching, Sarawak Malaysia.

Background: Hypokalemia in the presence of hypertension is often attributed to primary hyperaldosteronism as a cause of secondary hypertension, however secondary hyperaldosteronism may present similarly. Accessory renal arteries are variants in the vascular anatomy which are often thought to be innocuous but in some circumstances can cause renovascular hypertension leading to secondary hyperaldosteronism.

Case Presentation: We report 2 cases of hypertension with secondary hyperaldosteronism associated with accessory renal arteries. Read More

Hypertens Res 2019 Jan 6;42(1):40-51. Epub 2018 Nov 6.

Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.

It remains unknown which surrogate markers can predict diagnostic test results for primary hyperaldosteronism (PA). The Secondary Hypertension Registry Investigation in Mie Prefecture (SHRIMP) study has sequentially and prospectively recruited 128 patients with hypertension with an aldosterone-to-renin ratio (ARR) greater than 20, evaluated the differences among essential hypertension (EHT), idiopathic hyperaldosteronism (IHA), and aldosterone-producing adenoma (APA), and analyzed the predictors for the confirmatory tests. The patients underwent saline-loading, captopril-challenge, and upright furosemide-loading tests. Read More

J Endocr Soc 2018 Nov 17;2(11):1236-1245. Epub 2018 Sep 17.

Department of Rheumatology, Endocrinology, and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Context: The involvement of visceral fat in aldosterone secretion has not been reported in patients with primary aldosteronism (PA). Patients with PA are complicated by metabolic syndrome more frequently than those without PA. An excess of visceral fat has been hypothesized to cause an elevation of aldosterone secretion in patients with PA. Read More

Circulation 2018 Aug;138(8):823-835

Division of Metabolism, Endocrinology, and Diabetes (A.F.T., R.J.A.).

Primary aldosteronism (PA) is the most common form of secondary hypertension. In many cases, somatic mutations in ion channels and pumps within adrenal cells initiate the pathogenesis of PA, and this mechanism might explain why PA is so common and suggests that milder and evolving forms of PA must exist. Compared with primary hypertension, PA causes more end-organ damage and is associated with excess cardiovascular morbidity, including heart failure, stroke, nonfatal myocardial infarction, and atrial fibrillation. Read More

J Clin Med 2018 Oct 24;7(11). Epub 2018 Oct 24.

Department of Internal Medicine, Division of Nephrology, National Taiwan University Hospital, Taipei 100, Taiwan.

The use of statin therapy on the prevention of atherosclerotic cardiovascular disease (ASCVD) is recommended by the American College of Cardiology (ACC) and the American Heart Association (AHA); nevertheless, its validation on primary aldosteronism (PA) patients has not been reported. We investigated the risk of incident ASCVD in middle-aged patients with PA compared with essential hypertension (EH) based on ACC/AHA recommendations. We enrolled 461 PA patients and 553 EH patients. Read More

Hypertension 2018 Oct;72(4):874-880

Department of Molecular and Integrative Physiology (W.E.R.), and Department of Medicine (W.E.R.), University of Michigan, Ann Arbor.

Primary aldosteronism affects ≈5% to 10% of hypertensive patients and has unilateral and bilateral forms. Most unilateral primary aldosteronism is caused by computed tomography-detectable aldosterone-producing adenomas, which express CYP11B2 (aldosterone synthase) and frequently harbor somatic mutations in aldosterone-regulating genes. The cause of the most common bilateral form of primary aldosteronism, idiopathic hyperaldosteronism (IHA), is believed to be diffuse hyperplasia of aldosterone-producing cells within the adrenal cortex. Read More

Surgery 2019 Jan 19;165(1):219-220. Epub 2018 Oct 19.

Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.

Ann Cardiol Angeiol (Paris) 2018 Nov 14;67(5):315-320. Epub 2018 Oct 14.

Centre d'excellence en hypertension artérielle, hôpital St-André, CHU de Bordeaux, 1, rue Jean-Burguet, 33000 Bordeaux, France.

Objective: Primary hyperaldosteronism is the leading cause of secondary hypertension, and leads to frequent cardiovascular complications. Many studies have studied left ventricular geometry and function in this population, but longitudinal systolic function is still poorly described.

Methods: We studied 35 hypertensive patients with primary aldosteronism, and 35 with essential hypertension matched for age, sex, body mass index, and 24h blood pressure. Read More

Eur Heart J Cardiovasc Imaging 2019 03;20(3):263-270

Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.

Aims: Sodium intake has been linked to left ventricular hypertrophy independently of blood pressure, but the underlying mechanisms remain unclear. Primary hyperaldosteronism (PHA), a condition characterized by tissue sodium overload due to aldosterone excess, causes accelerated left ventricular hypertrophy compared to blood pressure matched patients with essential hypertension. We therefore hypothesized that the myocardium constitutes a novel site capable of sodium storage explaining the missing link between sodium and left ventricular hypertrophy. Read More

Eur J Endocrinol 2018 10 1;179(4):261-267. Epub 2018 Oct 1.

Department of Medicine I, Division of Endocrinology and Diabetology, University Hospital, University of Würzburg, Würzburg, Germany

Objective: Adrenal vein sampling (AVS) represents the current diagnostic standard for subtype differentiation in primary aldosteronism (PA). However, AVS has its drawbacks. It is invasive, expensive, requires an experienced interventional radiologist and comes with radiation exposure. Read More

PLoS One 2018 20;13(9):e0204390. Epub 2018 Sep 20.

Biomedical Department, Universitas Indonesia, Jakarta, Indonesia.

Background: Neuroglobin (Ngb) is highly expressed in the suprachiasmatic nucleus, and can regulate Per1 gene expression. It is still not known whether Ngb also influences Cryptochrome (Cry). Cry is implicated in hypertension and primary aldosteronism (PA) in mice. Read More

Ann Transl Med 2018 Aug;6(15):293

Tulane University School of Medicine, Tulane Heart and Vascular Institute, New Orleans, Louisiana, USA.

Background: The accurate identification and diagnosis of secondary hypertension is critical, especially while atherosclerotic cardiovascular heart disease continues to be the leading cause of death in the industrialized world. Nevertheless, despite the existence of diagnostic tools, there are significant variations of the estimated prevalence of secondary hypertension, due to multiple etiologies and suboptimal recognition. This study demonstrates the results of using a systematic and protocolled approach to improve recognition of the presence of secondary hypertension. Read More

Exp Clin Endocrinol Diabetes 2019 Feb 10;127(2-03):93-99. Epub 2018 Sep 10.

Medizinische Klinik und Poliklinik IV, Ludwig Maximilian University, Munich, Germany.

Primary aldosteronism is a common cause of endocrine hypertension. It results from the excess production of aldosterone by the adrenal cortex and is related to increased morbidity and mortality. Most cases of PA are sporadic but inherited patterns of the disease have been reported in the literature. Read More

J Clin Endocrinol Metab 2018 Dec;103(12):4456-4464

Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Context: Recently, the relationship between primary aldosteronism (PA) and various metabolic disorders, including obesity, diabetes mellitus, and dyslipidemia, has been discussed. However, in PA, aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) have different etiologies.

Objective: Our objectives were to clarify differences in obesity and metabolic disorders between APA and IHA and to gain insight in the pathogenesis of IHA. Read More

Exp Clin Endocrinol Diabetes 2019 Feb 21;127(2-03):100-108. Epub 2018 Aug 21.

Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany.

The importance of an early diagnosis and appropriate management of patients with primary aldosteronism (PA) has become increasingly clear because of the adverse impact of the disorder on cardiovascular and cerebrovascular events and target organ damage. Adrenalectomy potentially cures patients with unilateral PA resulting in normalisation of blood pressure or significant clinical improvements in the majority of patients. Different criteria have been used to evaluate outcomes of unilateral adrenalectomy. Read More

Urol J 2018 Aug 16. Epub 2018 Aug 16.

Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.

We encountered 2 patients (a 33-year-old woman and a 66-year-old man) with an aldosterone-producing adenoma (APA) and a left accessory spleen. The patients' primary symptoms were hypertension and hypokalemia, and both had elevated serum aldosterone levels. Preoperative computed tomography a left suprarenal retroperitoneal mass and laparoscopic left adrenalectomy was performed in both cases. Read More