Diagnosis of primary aldosteronism and the algorithm of interaction between a cardiologist and an endocrinologist from the position of a cardiologist
DOI:
https://doi.org/10.21638/10.21638/spbu11.2023.301Abstract
Primary aldosteronism is one of the most common causes of secondary arterial hypertension.The probability of its detection is especially high in patients with hypertension resistant to ongoing therapy. The purpose of the review is to analyze the causes of underdiagnosis of primary aldosteronism based on the data of modern publications, discuss the main trends in approaches to identifying this pathological condition, and justify the need for closer interaction between all specialists involved in the process of providing medical care to patients of this category. The review provides data on the groups of patients in whom it is most helpful to
screen primary aldosteronism, and the frequency of this screening in real practice. The advantages and disadvantages of using various criteria for the primary diagnosis of primary aldosteronism are analyzed. The need for common approaches to the methodology of examination and management of patients with suspected primary aldosteronism is discussed for general practitioners, therapists, cardiologists, organizers of laboratory services and endocrinologists. The negative consequences of long-term exposure to elevated levels of aldosterone on the cardiovascular system of patients with primary aldosteronism, their cardiovascular prognosis are analyzed. The necessity of the most thorough identification of patients with primary aldosteronism subject to surgical treatment is substantiated. Criteria for the effectiveness of
drug therapy in case of non-indication or impossibility of performing surgical intervention are given.
Keywords:
arterial hypertension, primary aldosteronism, cardiovascular consequences of primary aldosteronism, criteria for the effectiveness of drug therapy for primary aldosteronism
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References
Литература
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Seccia T. M., Carocci B., Adler G. K., Maiolino G., Cesari M., Rossi G. P. Arterial hypertension, atrial fibrillation, and hyperaldosteronism: The triple trouble. Hypertension, 2017, vol. 69, pp. 545–550.
Seccia T. M., Letizia C., Muiesan M. L., Lerco S., Cesari M., Bisogni V., Petramala L., Maiolino G., Volpin R., Rossi G. P. Atrial fibrillation as presenting sign of primary aldosteronism: Results of the Prospective Appraisal on the Prevalence of Primary Aldosteronism in Hypertensive (PAPPHY) study.Journal of Hypertension, 2019, vol. 38, no. 2, pp. 332–339.
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Hundemer G. L., Curhan G. C., Yozamp N., Wang M., Vaidya A. Incidence of Atrial Fibrillation and Mineralocorticoid Receptor Activity in Patients with Medically and Surgically Treated Primary Aldosteronism. JAMA Cardiol., 2018, vol. 3, no. 8, pp. 768–774.
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Published
2024-03-19
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Shurygina, V. . (2024). Diagnosis of primary aldosteronism and the algorithm of interaction between a cardiologist and an endocrinologist from the position of a cardiologist. Vestnik of Saint Petersburg University. Medicine, 18(3), 214–232. https://doi.org/10.21638/10.21638/spbu11.2023.301
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Articles of "Vestnik of Saint Petersburg University. Medicine" are open access distributed under the terms of the License Agreement with Saint Petersburg State University, which permits to the authors unrestricted distribution and self-archiving free of charge.
