Diagnosis of primary aldosteronism - debate continues. Part I

Abstract

Primary aldosteronism has been first described by Polish doctor, Michał Lityński in 1953. Improved screening methods have showed that primary aldosteronism is more common than it has been previously suspected. It has been estimated that primary aldosteronism affects 5–10% of patients with hypertension. Idiopathic bilateral adrenal hyperplasia and aldosterone producing adrenal adenoma are the leading causes of primary aldosteronism. The diagnosis of primary aldosteronism must be confirmed by demonstrating autonomous aldosterone secretion with confirmatory testing. The subtype evaluation is based on biochemical and localizing methods. Because of the deleterious cardiovascular effects of excess of aldosterone, normalization of circulating aldosterone or aldosterone receptor blockade should be part of the management plan for all patients with primary aldosteronism.