Primary Autonomous Aldosterone Secretion – New Concepts and Therapeutic Opportunities
Author: Kamenova, Teodora K.1, Elenkova, Atanaska P.1, Zacharieva, Sabina Z.1
Abstracts:
Primary aldosteronism (PA) is the most common form of endocrine hypertension with a frequency between 6 and 20% depending on the severity. It is characterized by renin-independent aldosterone hypersecretion. It is relatively autonomous from the main regulators (angiotensin II, potassium concentration) and is not suppressed by sodium loading. There is a continuum of renin- independent (autonomous) aldosteronism. Even normal aldosterone levels, with suppressed plasma renin activity (PRA), activate the mineralocorticoid receptor (MCR). Therefore, the risk of developing arterial hypertension increases not only among hypertensives, but also in the normotensive population. Aldosterone producingcell clusters (APCCs) in morphologically normal adrenal glands are the histopathological basis for normotensive aldosteronism.
Timely treatment of renin-independent aldosteronism makes it possible to prevent cardiovascular complications at an early stage. This extends the use of mineralocorticoid receptor antagonists not only at resistant hypertension. In case of lateralization (unilateral form of PA), surgical treatment is applied (laparoscopic adrenalectomy).