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Surg Clin North Am. 2019 Aug;99(4):731-745. doi: 10.1016/j.suc.2019.04.010.

Evaluation and Management of Primary Hyperaldosteronism.

Author information

1
Department of General Surgery, Northwestern University Feinberg School of Medicine, 675 North Saint Clair Street, Suite 3-150, Chicago, IL 60611, USA.
2
Section of Endocrine Surgery, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 650, Chicago, IL 60611, USA. Electronic address: delaraj@nm.org.

Abstract

Primary hyperaldosteronism is an important and increasingly prevalent cause of hypertension that is characterized by unregulated aldosterone excess. More than 90% of primary hyperaldosteronism cases are attributable to either idiopathic adrenal hyperplasia or aldosterone-producing adenomas. The approach to the diagnosis of primary hyperaldosteronism should be step-wise, starting with screening of at-risk populations, confirmatory testing for positively screened patients, and subtype classification in order to direct surgical or medical management. Based on current guidelines, subtype classification of primary hyperaldosteronism should be determined with both imaging and adrenal vein sampling (AVS), reserving deferment of AVS for a selective subset of patients.

KEYWORDS:

Adenoma; Adrenal hyperplasia; Aldosterone excess; Hyperaldosteronism; Primary hyperaldosteronism

PMID:
31255203
DOI:
10.1016/j.suc.2019.04.010
[Indexed for MEDLINE]

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