Primary Aldosteronism

Primary aldosteronism (Conn syndrome) is a syndrome of HTN and hypo-kalemia caused by hypersecretion of the mineralocorticoid aldosterone. This uncommon syndrome previously accounted for less than 1 percent of unse-lected patients with HTN. However, recent data examining routine screening suggest that aldosteronism may be the cause of up to 15 percent of cases of HTN. An aldosterone-producing adrenal adenoma (APA) is the cause of primary aldosteronism in two-thirds of cases and is one of the few surgically correctable causes of HTN. Idiopathic bilateral adrenal hyperplasia (IHA) causes 30-40 percent of cases of primary aldosteronism. Adrenocortical carcinoma and autosomal dominant glucocorticoid-suppressible aldosteronism are rare causes of primary aldosteronism. Secondary aldosteronism is a physiologic response of the renin-angiotensin system to renal artery stenosis, cirrhosis, congestive heart failure, and normal pregnancy. In these conditions, the adrenal gland functions normally.

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