Primary aldosteronism (PA) is an underdiagnosed cause of endocrine hypertension, distinguished by uncontrolled overproduction of aldosterone, unrelated to renin function, hypokalemia, or volume status. PA marked by the excessive production of aldosterone from the unilateral or bilateral adrenal cortex exhibits a wide range of presentations, varying from hyperplasia to aldosterone-producing micro or macro adenomas, and culminating in aldosterone-producing carcinoma.
There is variability in the prevalence of PA which depends on the population to which it refers, and the criteria used to confirm the diagnosis. Many studies are limited by using tests that do not definitively confirm the diagnosis. Therefore, many patients are incorrectly labeled as having primary hypertension without being evaluated for primary aldosteronism. As a result, a significant number of patients continue to be exposed to the harmful effects of excessive aldosterone production, emphasizing the importance of early detection and intervention due to the association of this syndrome with adverse cardiovascular and renal outcomes. Many studies in this area highlight the need for clinical changes in the management of PA.
This article aims not only to review current PA screening practices, but to highlight new evidence suggesting that renin-independent aldosterone overproduction occurs throughout the spectrum of arterial pressure severity, and the important role of the multidisciplinary team in its management. We highlight the critical need for diagnosing and promptly treating this syndrome, offering practical approaches to adjust clinical practices to achieve this goal.
Keywords: overproduction, aldosteronism, renin, hypokalemia.
Full text sources https://doi.org/10.31688/ABMU.2024.59.4.11
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Ergita NELAJ
Department of Internal Medicine, University Hospital Center “Mother Teresa”, Tirana, Albania
Address: Dibra’s Street, No 370, Tirana, Albania
Email: dr_ergi@yahoo.com; Phone +35-569-206-6148
