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Horm Metab Res 2015; 47(13): 973-980
DOI: 10.1055/s-0035-1565124
Review

Cardiovascular Risk in Primary Hyperaldosteronism

A. Prejbisz
1   Department of Hypertension, Institute of Cardiology, Warsaw, Poland
,
E. Warchoł-Celińska
1   Department of Hypertension, Institute of Cardiology, Warsaw, Poland
,
J. W. M. Lenders
2   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
3   Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universitat Dresden, Dresden, Germany
,
A. Januszewicz
1   Department of Hypertension, Institute of Cardiology, Warsaw, Poland
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Abstract

After the first cases of primary aldosteronism were described and characterized by Conn, a substantial body of experimental and clinical evidence about the long-term effects of excess aldosterone on the cardiovascular system was gathered over the last 5 decades. The prevalence of primary aldosteronism varies considerably between different studies among hypertensive patients, depending on patient selection, the used diagnostic methods, and the severity of hypertension. Prevalence rates vary from 4.6 to 16.6% in those studies in which confirmatory tests to diagnose primary aldosteronism were used. There is also growing evidence indicating that prolonged exposure to elevated aldosterone concentrations is associated with target organ damage in the heart, kidney, and arterial wall, and high cardiovascular risk in patients with primary aldosteronism. Therefore, the aim of treatment should not be confined to BP normalization and hypokalemia correction, but rather should focus on restoring the deleterious effects of excess aldosterone on the cardiovascular system. Current evidence convincingly demonstrates that both surgical and medical treatment strategies beneficially affect cardiovascular outcomes and mortality in the long term. Further studies can be expected to provide better insight into the relationship between cardiovascular risk and complications and the genetic background of primary aldosteronism.

Key words

aldosterone - cardiovascular event - target organ damage - blood pressure


Publication History

Received: 20 August 2015

Accepted: 12 October 2015

Article published online:
17 November 2015

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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