| Management of primary aldosteronism: its complications and their outcomes after treatment. | |
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MedLine Citation:
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PMID: 19356005 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Gilberta Giacchetti; Federica Turchi; Marco Boscaro; Vanessa Ronconi |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current vascular pharmacology Volume: 7 ISSN: 1570-1611 ISO Abbreviation: Curr Vasc Pharmacol Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-09 Completed Date: 2009-06-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101157208 Medline TA: Curr Vasc Pharmacol Country: United Arab Emirates |
Other Details:
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Languages: eng Pagination: 244-49 Citation Subset: IM |
Affiliation:
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Division of Endocrinology, Azienda Ospedaliero-Universtaria, Ospedali Riuniti Umberto I-GM Lancisi-G Salesi, Università Politecnica delle Marche, Via Conca 71, 60020 Torrette, Ancona, Italy. g.giacchetti@ospedaliriuniti.marche.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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complications,
surgery Adrenal Gland Neoplasms / complications, surgery Adrenal Glands / pathology* Adrenalectomy Blood Pressure Humans Hyperaldosteronism / complications, etiology, therapy* Hyperplasia Hypertension / etiology, prevention & control* Renin-Angiotensin System |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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