Primary aldosteronism: Diagnosis and treatment

William Francis Young, M. J. Hogan, G. G. Klee, C. S. Grant, J. A. Van Heerden

Research output: Contribution to journalArticle

162 Citations (Scopus)

Abstract

The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalamia 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, hpyertension persists; thus, the initial treatment in these patients should be pharmacologic.

Original languageEnglish (US)
Pages (from-to)96-110
Number of pages15
JournalMayo Clinic Proceedings
Volume65
Issue number1
StatePublished - 1990

Fingerprint

Hyperaldosteronism
Hypokalemia
Aldosterone
Renin
Hypertension
Adenoma
Signs and Symptoms
Hyperplasia
Hydrocortisone
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Young, W. F., Hogan, M. J., Klee, G. G., Grant, C. S., & Van Heerden, J. A. (1990). Primary aldosteronism: Diagnosis and treatment. Mayo Clinic Proceedings, 65(1), 96-110.

Primary aldosteronism : Diagnosis and treatment. / Young, William Francis; Hogan, M. J.; Klee, G. G.; Grant, C. S.; Van Heerden, J. A.

In: Mayo Clinic Proceedings, Vol. 65, No. 1, 1990, p. 96-110.

Research output: Contribution to journalArticle

Young, WF, Hogan, MJ, Klee, GG, Grant, CS & Van Heerden, JA 1990, 'Primary aldosteronism: Diagnosis and treatment', Mayo Clinic Proceedings, vol. 65, no. 1, pp. 96-110.
Young WF, Hogan MJ, Klee GG, Grant CS, Van Heerden JA. Primary aldosteronism: Diagnosis and treatment. Mayo Clinic Proceedings. 1990;65(1):96-110.
Young, William Francis ; Hogan, M. J. ; Klee, G. G. ; Grant, C. S. ; Van Heerden, J. A. / Primary aldosteronism : Diagnosis and treatment. In: Mayo Clinic Proceedings. 1990 ; Vol. 65, No. 1. pp. 96-110.
@article{cbbb4a944717484f93c358f4f540bf32,
title = "Primary aldosteronism: Diagnosis and treatment",
abstract = "The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalamia 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, hpyertension persists; thus, the initial treatment in these patients should be pharmacologic.",
author = "Young, {William Francis} and Hogan, {M. J.} and Klee, {G. G.} and Grant, {C. S.} and {Van Heerden}, {J. A.}",
year = "1990",
language = "English (US)",
volume = "65",
pages = "96--110",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "1",

}

TY - JOUR

T1 - Primary aldosteronism

T2 - Diagnosis and treatment

AU - Young, William Francis

AU - Hogan, M. J.

AU - Klee, G. G.

AU - Grant, C. S.

AU - Van Heerden, J. A.

PY - 1990

Y1 - 1990

N2 - The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalamia 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, hpyertension persists; thus, the initial treatment in these patients should be pharmacologic.

AB - The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalamia 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, hpyertension persists; thus, the initial treatment in these patients should be pharmacologic.

UR - http://www.scopus.com/inward/record.url?scp=0025134080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025134080&partnerID=8YFLogxK

M3 - Article

C2 - 2404167

AN - SCOPUS:0025134080

VL - 65

SP - 96

EP - 110

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 1

ER -