Primary hyperaldosteronism natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
If left untreated, patients with primary hyperaldosteronism may progress to develop stroke, coronary artery disease, and renal insufficiency with associated proteinuria. APAs continue to grow slowly over time. The aldosterone production likely correlates with the size of the adenoma. Primary hyperladosteronism can be progressive leading to increased severity of disease. Common complications of primary hyperaldosteronism include left ventricular hypertrophy due to chronic hypertension, atrial fibrillation, myocardial infarction, stroke, proteinuria and metabolic syndrome.
Natural History
- The natural history of primary hyperaldosteronism other than familial hyperaldosteronism type I (FH-I) is for progressive increase in disease severity, ebentually leading to involvement of both adrenals.[1]
- If left untreated, patients with primary hyperaldosteronism may progress to develop severe resistant hypertension leading to stroke, coronary artery disease, and renal insufficiency with associated proteinuria.[2]
Complications
Primary aldosteronism is characterized by the development of the following complications:[3][4][5][6]
Cardiovascular complications
- Left ventricular hypertrophy
- Myocardial infarction
- Atrial fibrillation
Neurological complications
- Stroke
- Hypertensive encephelopathy
Renal complications
- Proteinuria including microalbuminuria
- Renal cysts
Metabolic complications
- Metabolic syndrome
- Diabetes mellitus
Prognosis
References
- ↑ Gordon RD (1997). "Primary aldosteronism: a new understanding". Clin. Exp. Hypertens. 19 (5–6): 857–70. PMID 9247760.
- ↑ "Cardiovascular complications in patients with primary aldosteronism - ScienceDirect".
- ↑ Nishimura M, Uzu T, Fujii T, Kuroda S, Nakamura S, Inenaga T, Kimura G (1999). "Cardiovascular complications in patients with primary aldosteronism". Am. J. Kidney Dis. 33 (2): 261–6. PMID 10023636.
- ↑ Giacchetti G, Turchi F, Boscaro M, Ronconi V (2009). "Management of primary aldosteronism: its complications and their outcomes after treatment". Curr Vasc Pharmacol. 7 (2): 244–49. PMID 19356005.
- ↑ Reincke M, Meisinger C, Holle R, Quinkler M, Hahner S, Beuschlein F, Bidlingmaier M, Seissler J, Endres S (2010). "Is primary aldosteronism associated with diabetes mellitus? Results of the German Conn's Registry". Horm. Metab. Res. 42 (6): 435–9. doi:10.1055/s-0029-1246189. PMID 20119885.
- ↑ Hanslik G, Wallaschofski H, Dietz A, Riester A, Reincke M, Allolio B, Lang K, Quack I, Rump LC, Willenberg HS, Beuschlein F, Quinkler M, Hannemann A (2015). "Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn's Registry". Eur. J. Endocrinol. 173 (5): 665–75. doi:10.1530/EJE-15-0450. PMID 26311088.