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Horm Metab Res 2015; 47(13): 935-940
DOI: 10.1055/s-0035-1565182
Review

Primary Aldosteronism: New Answers, New Questions

J. W. Funder
1   Hudson Institute of Medical Research and Monash University, Clayton, Australia
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Abstract

There have been 2, and possibly 3, major questions for primary aldosteronism (PA) answered at least in principle over the past 5 years. The first is that of somatic mutations underlying the majority of aldosterone producing adenomas. The second is the extension of our knowledge of the genetics of familial hypertension, and the third the role of renal intercalated cells in sodium homeostasis. New questions for the next 5 years include a single accepted confirmatory/exclusion test; standardisation of assays and cut-offs; alternatives to universal adrenal venous sampling; reclassification of ‘low renin hypertension’; recognition of the extent of ‘occult’ PA; inclusion of low-dose mineralocorticoid receptor antagonist in first-line therapy for hypertension; and finally, possible resolution of the aldosterone/inappropriate sodium status enigma at the heart of the cardiovascular damage in PA.

Key words

aldosterone - familial hyperaldosteronism type II and III - lateralisation - APA - ACTH - endogenous ouabain - mineralocorticoid receptor antagonist


Publication History

Received: 18 August 2015

Accepted: 19 October 2015

Article published online:
20 November 2015

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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