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 [disease name] include [complication 1], [complication 2], and [complication 3]. Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

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.
• 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.

Complications

Primary aldosteronism is characterized by the development of the following complications: 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