High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It
Issued Date
2022-05-01
Resource Type
ISSN
15226417
eISSN
15343111
Scopus ID
2-s2.0-85124747880
Pubmed ID
35165831
Journal Title
Current Hypertension Reports
Volume
24
Issue
5
Start Page
123
End Page
132
Rights Holder(s)
SCOPUS
Bibliographic Citation
Current Hypertension Reports Vol.24 No.5 (2022) , 123-132
Suggested Citation
Wannachalee T., Lieberman L., Turcu A.F. High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It. Current Hypertension Reports Vol.24 No.5 (2022) , 123-132. 132. doi:10.1007/s11906-022-01176-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87324
Title
High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Purpose of Review: Primary aldosteronism (PA) affects millions of individuals worldwide. When unrecognized, PA leads to cardiovascular and renal complications via mechanisms independent from those mediated by hypertension. In this review, we emphasize the importance of PA screening in at-risk populations, and we provide options for customized PA therapy, with consideration for a variety of clinical care settings. Recent Findings: Compelling evidence puts PA at the forefront of secondary hypertension etiologies. Cardiovascular and renal damage likely begins in early stages of renin-independent aldosterone excess. PA must be considered not only in patients with resistant hypertension or hypokalemia, but also when hypertension is associated with obstructive sleep apnea or atrial fibrillation, or in those with early-onset hypertension. Screening with plasma aldosterone and renin is widely accessible, and targeted PA therapy can successfully circumvent the excess cardiorenal risk relative to equivalent primary hypertension. Summary: Identifying and treating PA in early stages provide opportunities for personalized hypertension therapy in a large number of patients. Additionally, early targeted therapy of PA is essential for pivoting the care of such patients from reactive to preventive of cardiovascular and renal morbidity and mortality.