Review
Hyperaldosteronism: recent concepts, diagnosis, and management
R Foo, K M O'Shaughnessy, M J BrownClinical
Pharmacology Unit, University of Cambridge, Box 110, Addenbrooke's
Hospital, Cambridge CB2 2QQ, UK
Correspondence to: Dr Foo rf226@medschl.cam.ac.uk
Submitted 27 February
2001;
Accepted 23 April 2001
| The first 150 words of the full text of this article appear below. |
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Introduction |
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As a cause for hypertension, aldosterone excess is now
thought to be more prevalent than previously quoted in textbooks.
Classical features of hypokalaemia and metabolic alkalosis can be
absent even in the presence of marked hypertension. This implies the need for a high index of suspicion and possibly argues the case for
routine screening, especially in patients with "difficult to treat"
hypertension. Given multisystem target organ damage and increased
cardiovascular risk associated with chronic uncontrolled hypertension,
a readily treatable cause such as hyperaldosteronism is an important
diagnosis to make. In addition, hyperaldosteronism related hypertension
is now known to cover other recently identified monogenic disorders
such as glucocorticoid remediable aldosteronism. These rarer monogenic
hypertensive disorders provide clues to cracking the mystery behind
polygenic "essential" hypertension. Apart from patients with
hyperaldosteronism, a subset of the well recognised "low renin
hypertension" patient group also appears to produce a dramatic and
remarkable response when
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