Is Idiopathic Hyperaldosteronism a Variant of Essential Hypertension or of Conn’s Syndrome?
Primary hyperaldosteronism, or Conn’s syndrome, results from an aldosterone-producing adenoma of the adrenal cortex. It presents with features of mineralocorticoid excess — increased secretion of aldosterone, hypertension, hypernatraemia, increased exchangeable sodium, hypokalemia, low exchangeable potassium, and reduced plasma concentrations of renin and angiotensin II [1–3]. Removal of the tumour corrects the aldosterone excess, reverses the electrolyte abnormality, and often restores normal blood pressure . Clinicians and pathologists have little difficulty in accepting the disease as an entity.
KeywordsEssential Hypertension Primary Hyperaldosteronism Exchangeable Sodium Plasma Aldosterone Concentration Exchangeable Potassium
Unable to display preview. Download preview PDF.
- 3.Davies DL, Beever DG, Brown JJ, Gumming AMM, Fräser R, Lever AF, Mason PA, Morton JJ, Robertson JIS, Titterington M, Tree M (1979) Aldosterone and its stimuli in normal and hypertensive man: are essential hypertension and primary hyperaldosteronism without tumour the same condition? J Endocrinol 81: 79P–91 PPubMedGoogle Scholar
- 4.Liddle GW (1962) Discussion of ‘Secondary aldosteronism and reduced plasma renin in hypertensive disease’. Trans Assoc Am Physicians 80: 182Google Scholar
- 5.Baer L, Brunner HR, Buhler F, Laragh JH (1972) Pseudo-primary aldosteronism, a variant of low renin essential hypertension. In: Genest J, Koiw E (eds) Hypertension-1972. Springer, Berlin pp 459–472Google Scholar
- 8.Beretta-Piccoli C, Davies DL, Boddy K, Brown JJ, Cumming AMM, East BW, Fraser R, Lever AF, Padfield PL, Semple PF, Robertson JIS, Weidmann P, Williams ED (1982) Relation of arterial pressure with body sodium, body potassium and plasma potassium in essential hypertension. Clin Sci 63: 257–270PubMedGoogle Scholar
- 9.Beretta-Piccoli C, Davies DL, Brown JJ, Ferriss JB, Fraser R, Lever AF, Morton JJ, Robertson JIS (1982) The relation of arterial pressure with plasma and body electrolytes is similar in Conn’s syndrome and essential hypertension. Clin Sci 63: 89S–92SGoogle Scholar
- 10.Aitchison J, Brown JJ, Ferriss JB, Fraser R, Kay AW, Lever AF, Neville AM, Symington T, Robertson JIS (1971) Quadric analysis in the preoperative distinction between patients with and without adrenocortical tumors in hypertension with aldosterone excess and low plasma renin. Am Heart J 82: 660–671PubMedCrossRefGoogle Scholar
- 11.Fraser R, Beretta-Piccoli C, Brown JJ, Cumming AMM, Lever AF, Mason PA, Morton JJ, Robertson JIS (1981) Response of aldosterone and 18-hydroxycorticosterone to angiotensin II in normal subjects and patients with essential hypertension, Conn’s syndrome and non-tumorous hyperaldosteronism. Hypertension [Suppl 1] 3:1–87, 1–92Google Scholar
- 15.Vecsei P, Purjesz I, Wolff HP (1969) Studies on the biosynthesis of aldosterone in solitary adenoma and in nodular hyperplasia of the adrenal cortex in patients exhibiting Conn’s syndrome. Acta Endocrinol (Copenh) 62: 391–398Google Scholar
- 18.Gunnels JC, McGuffin WL, Robinson RR, Grim CE, Wells S, Silver D, Glenn JF (1970) Hypertension, adrenal abnormalities and alterations to plasma renin activity. Ann Intern Med 73: 901–911Google Scholar
- 31.Mill JS (1869) Analysis of the phenomenon of the human mind, vol. 2. LondonGoogle Scholar