The syndrome of primary aldosteronism.
TL;DR: Adrenocortical hyperplasia with or without tumor was as common a cause of the syndrome of primary aldosteronism as tumor alone and was as valuable for diagnosis as the determination of aldosterone secretion and excretion.
About: This article is published in The American Journal of Medicine.The article was published on 1970-03-01. It has received 92 citations till now. The article focuses on the topics: Hyperaldosteronism & Primary aldosteronism.
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DOI•
20 Nov 2006
TL;DR: 原发性醛固酮瘤及其主要的病理亚型, 为影像学检查的补充.
Abstract: 原发性醛固酮增多症(原醛症)是继发性高血压的常见病因之一,部分患者亦可伴有低血钾,醛固酮瘤及特发性醛固酮增多症是其主要的病理亚型.原醛症的诊断包括筛查、确诊及分型诊断3个步骤,传统影像学结合体位刺激的方法进行分型诊断,假阳性及假阴性率均较高,肾上腺静脉插管采血可作为影像学检查的补充.醛固酮瘤及原发性肾上腺增生患者应予手术治疗,特发性醛固酮增多症患者多采用药物治疗,螺内酯是其首选药物。
337 citations
TL;DR: The role of the kidney in blood-pressure regulation was established by TIGERSTEDT and Bergman at the close of the 19th century as discussed by the authors, who produced hypertension in dogs by injecting a cr...
Abstract: TIGERSTEDT and Bergman established a role for the kidney in blood-pressure regulation at the close of the 19th century. In a classic experiment, they produced hypertension in dogs by injecting a cr...
278 citations
TL;DR: Results indicate a wider clinical spectrum in primary aldosteronism than previously described and show that nonsuppressible aldosterone production is its most important diagnostic hallmark and the single best diagnostic screening procedure, and that adrenal venous sampling for plasma ald testosterone concentration remains the most precise technique for identification and localization of tumors.
252 citations
TL;DR: Nine normal subjects and 18 patients with essential hypertension had similar suppression of plasma aldosterone concentration to 5 ng/100 ml or less after intravenous infusion of 2 liters of isotonic saline during four hours of recumbency.
Abstract: Nine normal subjects and 18 patients with essential hypertension had similar suppression of plasma aldosterone concentration to 5 ng/100 ml or less after intravenous infusion of 2 liters of isotonic saline during four hours of recumbency. Six patients with aldosteronism and adrenal adenomas or glucocorticoid suppressible hyperplasia failed to suppress normally. One hypertensive hypokalemic patient with low plasma renin activity had elevated plasma deoxycorticosterone and failed to suppress his plasma aldosterone concentration below 5 ng/100 ml. Three of four patients with renovascular stenosis and hypertension suppressed normally. The fourth patient with a postinfusion plasma aldosterone concentration of 7 ng/100 ml was found to suppress normally when this value was expressed as percent of the two-hour upright value. This saline infusion, recumbency test is rapid and requires minimal patient preparation.
165 citations
01 Jan 1990
TL;DR: In most patients with bilateral adrenal hyperplasia who are treated surgically, however, hypertension persists; thus, the initial treatment in these patients should be pharmacologic.
Abstract: The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalemia or easily provoked hypokalemia is found in a patient with hypertension. Hypokalemia in association with inappropriate kaliuresis, low plasma renin activity, and a high plasma aldosterone concentration/plasma renin activity ratio are the findings on initial screening tests that should suggest primary aldosteronism. The diagnosis must be confirmed by demonstrating nonsuppressible aldosterone excretion in conjunction with normal cortisol excretion. The choice of therapy is based on distinguishing unilateral from bilateral adrenal disease. With a unilateral adrenal adenoma, surgical removal reverses the hypokalemia and frequently cures the hypertension. In most patients with bilateral adrenal hyperplasia who are treated surgically, however, hypertension persists; thus, the initial treatment in these patients should be pharmacologic.
163 citations
References
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Journal Article•
947 citations
685 citations
TL;DR: This report includes a detailed description of the method, assay results for human urine and dog adrenal vein plasma, and a critical evaluation of the specificity, precision, and accuracy of this technique.
574 citations
01 Jan 1963
421 citations
TL;DR: Arterial hypertension has been a consistent finding in patients withPrimary hyperaldosteronism and a number of other observations have suggested a relationship between the dietary sodium intake and the blood pressure level of patients with primary (benign essential) hypertension.
Abstract: After the synthesis of desoxycorticosterone (DOC), it became apparent that this corticosteroid, the physiological effects of which are concerned primarily with sodium and potassium metabolism, can produce a state of hypertension both in animals and in man (1, 2). The induced hypertension is dependent upon the administration of adequate amounts of dietary sodium, whereas the hypertensive state, produced by administration of glucocorticoids such as cortisone, differs in that it is independent of the dietary sodium content (3). More recently, following the chemical and biological characterization of the mineralocorticoid hormone, aldosterone (4), a disease state associated with primary hypersecretion of this hormone has been described in man (5). Aldosterone produces effects on sodium and potassium metabolism similar to those of desoxycorticosterone, and the clinical syndrome of primary aldosteronism resembles the disease state produced by chronic administration of DOCto dogs (6). Arterial hypertension has been a consistent finding in patients with primary hyperaldosteronism. A number of other observations have suggested a relationship between the dietary sodium intake and the blood pressure level of patients with primary (benign essential) hypertension. The beneficial effects of sodium deprivation, and of various natriuretic agents in certain patients with hypertension, is well known. In addition, other studies have suggested that abnormalities of intracellular sodium and potassium content may occur in patients with arterial hypertension (7). Genest, Koiw, Nowaczynski and Lebouef (8) have re-
284 citations