Abstract
Primary aldosteronism is the most common cause of secondary hypertension, accounting for about 10% of all forms of high blood pressure. Life-time pharmacological therapy is the treatment of choice for primary aldosteronism due to idiopathic adrenal hyperplasia (IHA), while adrenalectomy is effective in curing most patients with an aldosterone producing adenoma (APA). Far from being a benign form of hypertension, primary aldosteronism is characterized by the development of cardiovascular renal and metabolic complications, including left ventricular hypertrophy, myocardial infarction, atrial fibrillation and stroke, microalbuminuria, renal cysts as well as metabolic syndrome, glucose impairment and diabetes mellitus. We review recent clinical experience with the above mentioned complications and long-term outcomes of blood pressure normalization and cardiac, renal and gluco-metabolic complications in patients with primary aldosteronism, after medical treatment with mineralocorticoid receptor antagonists and surgical treatment. We conclude that removal of adrenal adenoma results in normalization of the renin-angiotensin-aldosterone system (RAAS) and of kalaemia and improvement of blood pressure levels in all patients. Complete resolution of hypertension is achieved in nearly half of treated patients. Moreover, unilateral adrenalectomy is the best treatment to have the regression of cardiovascular, renal and metabolic complications in patients with APA. On the other hand, targeted medical treatment with aldosterone antagonists improves blood pressure control and appears able to prevent the progression of cardiac and metabolic complications in patients with IHA.
Keywords: Primary aldosteronism, medical treatment, adrenalectomy, complications, mineralocorticoid receptor blockers
Current Vascular Pharmacology
Title: Management of Primary Aldosteronism: Its Complications and Their Outcomes After Treatment
Volume: 7 Issue: 2
Author(s): Gilberta Giacchetti, Federica Turchi, Marco Boscaro and Vanessa Ronconi
Affiliation:
Keywords: Primary aldosteronism, medical treatment, adrenalectomy, complications, mineralocorticoid receptor blockers
Abstract: Primary aldosteronism is the most common cause of secondary hypertension, accounting for about 10% of all forms of high blood pressure. Life-time pharmacological therapy is the treatment of choice for primary aldosteronism due to idiopathic adrenal hyperplasia (IHA), while adrenalectomy is effective in curing most patients with an aldosterone producing adenoma (APA). Far from being a benign form of hypertension, primary aldosteronism is characterized by the development of cardiovascular renal and metabolic complications, including left ventricular hypertrophy, myocardial infarction, atrial fibrillation and stroke, microalbuminuria, renal cysts as well as metabolic syndrome, glucose impairment and diabetes mellitus. We review recent clinical experience with the above mentioned complications and long-term outcomes of blood pressure normalization and cardiac, renal and gluco-metabolic complications in patients with primary aldosteronism, after medical treatment with mineralocorticoid receptor antagonists and surgical treatment. We conclude that removal of adrenal adenoma results in normalization of the renin-angiotensin-aldosterone system (RAAS) and of kalaemia and improvement of blood pressure levels in all patients. Complete resolution of hypertension is achieved in nearly half of treated patients. Moreover, unilateral adrenalectomy is the best treatment to have the regression of cardiovascular, renal and metabolic complications in patients with APA. On the other hand, targeted medical treatment with aldosterone antagonists improves blood pressure control and appears able to prevent the progression of cardiac and metabolic complications in patients with IHA.
Export Options
About this article
Cite this article as:
Giacchetti Gilberta, Turchi Federica, Boscaro Marco and Ronconi Vanessa, Management of Primary Aldosteronism: Its Complications and Their Outcomes After Treatment, Current Vascular Pharmacology 2009; 7 (2) . https://dx.doi.org/10.2174/157016109787455716
DOI https://dx.doi.org/10.2174/157016109787455716 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Advancements in Arterial Stiffness: Novel Therapeutic Frontiers
Arterial stiffness, a hallmark of cardiovascular disease, poses significant challenges in contemporary healthcare. This thematic issue delves into the multifaceted landscape of arterial stiffness and explores cutting-edge therapeutic interventions aimed at mitigating its adverse effects. Within these pages, readers will find a comprehensive overview of the mechanisms underlying arterial stiffness, ...read more
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Therapeutic Progress and Knowledge Basis on the Natriuretic Peptide System in Heart Failure
Current Topics in Medicinal Chemistry Novel and Practical Approaches to Manage Diet-induced Metabolic Disorders: Part-I
Current Pharmaceutical Design Functional Recovery After Stroke: A Review of Current Developments in Stroke Rehabilitation Research
Reviews on Recent Clinical Trials Targeting Soluble Epoxide Hydrolase for Inflammation and Pain - An Overview of Pharmacology and the Inhibitors
Inflammation & Allergy - Drug Targets (Discontinued) Autoimmune Hepatitis: Pathophysiology, Diagnosis and Pharmacological Therapy
Current Immunology Reviews (Discontinued) Flaxseed for Health and Disease: Review of Clinical Trials
Combinatorial Chemistry & High Throughput Screening Treatment of Pulmonary Thromboembolism in Patients with Systemic Blood Pressure Stability and Right Ventricular Dysfunction
Current Respiratory Medicine Reviews Immunomodulatory Effects of Medicinal Plants used for Vitiligo in Traditional Persian Medicine
Current Drug Discovery Technologies Insulin Therapy in Pregnancy Hypertensive Diseases and its Effect on the Offspring and Mother Later in Life
Current Vascular Pharmacology Hepatoma Derived Growth Factor is a Nuclear Targeted Mitogen
Current Drug Targets Therapeutic Potential of Neuregulin in Cardiovascular System: Can we Ignore the Effects of Neuregulin on Electrophysiology?
Mini-Reviews in Medicinal Chemistry Podocytes as a Target of Prorenin in Diabetes
Current Diabetes Reviews Biomarkers in Preeclamptic Women with Normoglycemia and Hyperglycemia
Current Hypertension Reviews Studies on Novel Pyridine and 2-pyridone Derivatives of N-arylpiperazine as α-adrenoceptor Ligands
Medicinal Chemistry Potential Phytotherapeutic Approaches for the Treatment of Alzheimer’s Disease: An Overview
Current Traditional Medicine Novel Caffeic Acid Phenethyl Ester (Cape) Analogues as Inducers of Heme Oxygenase-1
Current Pharmaceutical Design Mechanisms and Drug Targets for Pancreatic Cancer Chemoprevention
Current Medicinal Chemistry Co-ultraPEALut: Role in Preclinical and Clinical Delirium Manifestations
CNS & Neurological Disorders - Drug Targets Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary Intervention TIMI Frame Count in Patients with ST-segment Elevation Myocardial Infarction
Cardiovascular & Hematological Disorders-Drug Targets Fine Tuning of PPAR Ligands for Type 2 Diabetes and Metabolic Syndrome
Mini-Reviews in Medicinal Chemistry