Recent Development toward the Next Clinical Practice of Primary Aldosteronism: A Literature Review

Biomedicines

Yuto Yamazaki¹  Hironobu Sasano¹  Fumitoshi Satoh²  Yuta Tezuka²  Yasuhiro Nakamura³ 

[1] Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan;

关键词: primary aldosteronism;    aldosterone-producing adenoma;    bilateral hyperaldosteronism;    HISTOALDO consensus;    steroid profiling;    hypertension;   

DOI  :  10.3390/biomedicines9030310

来源: DOAJ

【 摘 要 】

For the last seven decades, primary aldosteronism (PA) has been gradually recognized as a leading cause of secondary hypertension harboring increased risks of cardiovascular incidents compared to essential hypertension. Clinically, PA consists of two major subtypes, surgically curable and uncurable phenotypes, determined as unilateral or bilateral PA by adrenal venous sampling. In order to further optimize the treatment, surgery or medications, diagnostic procedures from screening to subtype differentiation is indispensable, while in the general clinical practice, the work-up rate is extremely low even in the patients with refractory hypertension because of the time-consuming and labor-intensive nature of the procedures. Therefore, a novel tool to simplify the diagnostic flow has been recently in enormous demand. In this review, we focus on recent progress in the following clinically important topics of PA: prevalence of PA and its subtypes, newly revealed histopathological classification of aldosterone-producing lesions, novel diagnostic biomarkers and prediction scores. More effective strategy to diagnose PA based on better understanding of its epidemiology and pathology should lead to early detection of PA and could decrease the cardiovascular and renal complications of the patients.

【 授权许可】

Unknown