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Is Idiopathic Hyperaldosteronism a Variant of Essential Hypertension or of Conn’s Syndrome?

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Mineralocorticoids and Hypertension

Abstract

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 [2]. Clinicians and pathologists have little difficulty in accepting the disease as an entity.

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References

  1. Schalekamp MADH, Wenting GJ, Man in T’Veld AJ (1981) Pathogenesis of mineralocorticoid hypertension. Clinics in Endocrinology and Metabolism 10: 397–418

    Article  PubMed  CAS  Google Scholar 

  2. Ferriss JB, Brown JJ, Fräser R, Lever AF, Robertson JIS (1981) Primary hyperaldosteronism. Clin Endocrinol Metab 10: 419–452

    Article  PubMed  CAS  Google Scholar 

  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 P

    PubMed  CAS  Google Scholar 

  4. Liddle GW (1962) Discussion of ‘Secondary aldosteronism and reduced plasma renin in hypertensive disease’. Trans Assoc Am Physicians 80: 182

    Google 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 459–472

    Google Scholar 

  6. Neville AM (1978) The nodular adrenal. Invest Cell Pathol 1: 99–111

    PubMed  CAS  Google Scholar 

  7. Padfield PL, Brown J J, Davies DL, Fraser R, Lever AF, Morton J J, Robertson JIS (1981) The myth of idiopathic hyperaldosteronism. Lancet 2: 83–84

    Article  PubMed  CAS  Google 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: 257–270

    PubMed  CAS  Google 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–92S

    Google 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: 660–671

    Article  PubMed  CAS  Google 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, 1–92

    CAS  Google Scholar 

  12. Ferriss JB, Beevers DG, Brown JJ, Davies DL, Fraser R, Lever AF, Mason P, Neville AM, Robertson JIS (1978) Clinical, biochemical and pathological features of low-renin (‘primary’) hyperaldosteronism. Am Heart J 95: 375–388

    Article  PubMed  CAS  Google Scholar 

  13. Neville AM, O’Hare MJ (1982) The human adrenal cortex. Springer, Berlin, pp 202–241

    Book  Google Scholar 

  14. Usa T, Ganguly A, Weinberger MH (1980) Differences between adrenal adenoma causing primary aldosteronism and other adrenal tissues in the incorporation of labelled steroid precursors into their products. Steroids 36: 531–545

    Article  PubMed  CAS  Google 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: 391–398

    CAS  Google Scholar 

  16. Carroll JE, Campanile CP, Goodfriend TL (1982) The effect of prolactin on human aldosterone-producing adenomas in vitro. J Clin Endocrinol Metab 54: 689–692

    Article  PubMed  CAS  Google Scholar 

  17. Dobbie JW (1969) Adrenocortical nodular hyperplasia: the ageing adrenal. J Pathology 99: 1–18

    Article  CAS  Google 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: 901–911

    Google Scholar 

  19. Grim CE, Peters TJ (1971) Low renin hypertension: a state of inappropriate secretion of aldosterone. J Lab Clin Med 78: 816–817

    PubMed  CAS  Google Scholar 

  20. Brown J J, Lever AF, Robertson JIS, Beevers DG, Cumming AMM, Davies DL, Fraser R, Mason P, Morton JJ, Tree M (1979) Are idiopathic hyperaldosteronism and low renin hypertension variants of essential hypertension? Ann Clin Biochem 16: 380–388

    PubMed  CAS  Google Scholar 

  21. Padfield PL, Beevers DG, Brown JJ, Davies DL, Lever AF, Robertson JIS, Tree M (1975) Is low-renin hypertension a stage in the development of essential hypertension or a diagnostic entity? Lancet 1: 548–550

    Article  PubMed  CAS  Google Scholar 

  22. Schalekamp MADH, Schalekamp-Kuyken MPA, Birkenhager WH (1970) Abnormal renal haemodynamics and renin suppression in hypertensive patients. Clin Sci 38: 101–110

    PubMed  CAS  Google Scholar 

  23. Wisgerhof M, Carpenter PC, Brown RD (1978) Increased adrenal sensitivity to angiotensin II in idiopathic hyperaldosteronism. J Clin Endocrinol Metab 47: 938–943

    Article  PubMed  CAS  Google Scholar 

  24. McAreavey D, Murray GD, Lever AF, Robertson JIS (1983) Similarity of idiopathic aldosteronism and essential hypertension: a statistical comparison. Hypertension 5: 116–121

    PubMed  CAS  Google Scholar 

  25. Vetter H, Berger M, Armbruster H, Siegenthaler W, Werning C, Vetter W (1974) Episodic secretion of aldosterone in primary aldosteronism: relationship to Cortisol. Clin Endocrinol 3: 41–48

    Article  CAS  Google Scholar 

  26. Kem DC, Weinberger MH, Gomez-Sanchez C, Kramer NJ, Larman R, Furuyama S, Nugent CA (1973) Circadian rhythm of plasma aldosterone concentration in patients with primary aldosteronism. J Clin Invest 52: 2272

    Article  PubMed  CAS  Google Scholar 

  27. Ganguly A, Melada GA, Luetscher JA, Dowdy AJ (1973) Control of plasma aldosterone in primary aldosteronism. Distinction between adenoma and hyperplasia. J Clin Endocrinol Metab 37: 765–775

    Article  PubMed  CAS  Google Scholar 

  28. Collins RD, Weinberger MH, Dowdy AJ, Nokes GW, Gonzales CM, Luetscher JA (1970) Abnormally sustained aldosterone secretion during salt loading in patients with various forms of benign hypertension: relation to plasma renin activity. J Clin Invest 49: 1415–1426

    Article  PubMed  CAS  Google Scholar 

  29. Helber A, Wambach G, Hummerich W, Bonner G, Meurer KA, Kaufmann W (1980) Evidence for a subgroup of essential hypertensives with non-suppres- sible excretion of aldosterone during sodium loading. Klin Wochenschr 58: 439–447

    Article  PubMed  CAS  Google Scholar 

  30. Genest J, Nowaczynski W, Boucher R, Rojo-Ortega JM (1977) The role of the adrenal cortex in human essential hypertension. Mayo Clin Proc 52: 291–307

    PubMed  CAS  Google Scholar 

  31. Mill JS (1869) Analysis of the phenomenon of the human mind, vol. 2. London

    Google Scholar 

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Lasaridis, A. et al. (1983). Is Idiopathic Hyperaldosteronism a Variant of Essential Hypertension or of Conn’s Syndrome?. In: Kaufmann, W., Wambach, G., Helber, A., Meurer, KA. (eds) Mineralocorticoids and Hypertension. International Boehringer Mannheim Symposia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69081-5_14

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  • DOI: https://doi.org/10.1007/978-3-642-69081-5_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-12391-0

  • Online ISBN: 978-3-642-69081-5

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