Title |
Primary Aldosteronism: Changing Definitions and New Concepts of Physiology and Pathophysiology Both Inside and Outside the Kidney
|
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Published in |
Physiological Reviews, August 2016
|
DOI | 10.1152/physrev.00026.2015 |
Pubmed ID | |
Authors |
Michael Stowasser, Richard D Gordon |
Abstract |
In the 60 years that have passed since the discovery of the mineralocorticoid hormone aldosterone, much has been learned about its synthesis (both adrenal and extra-adrenal), regulation (by renin-angiotensin II, potassium, adrenocorticotrophin, and other factors), and effects (on both epithelial and nonepithelial tissues). Once thought to be rare, primary aldosteronism (PA, in which aldosterone secretion by the adrenal is excessive and autonomous of its principal regulator, angiotensin II) is now known to be the most common specifically treatable and potentially curable form of hypertension, with most patients lacking the clinical feature of hypokalemia, the presence of which was previously considered to be necessary to warrant further efforts towards confirming a diagnosis of PA. This, and the appreciation that aldosterone excess leads to adverse cardiovascular, renal, central nervous, and psychological effects, that are at least partly independent of its effects on blood pressure, have had a profound influence on raising clinical and research interest in PA. Such research on patients with PA has, in turn, furthered knowledge regarding aldosterone synthesis, regulation, and effects. This review summarizes current progress in our understanding of the physiology of aldosterone, and towards defining the causes (including genetic bases), epidemiology, outcomes, and clinical approaches to diagnostic workup (including screening, diagnostic confirmation, and subtype differentiation) and treatment of PA. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 117 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 18 | 15% |
Student > Ph. D. Student | 13 | 11% |
Student > Master | 13 | 11% |
Researcher | 11 | 9% |
Other | 11 | 9% |
Other | 20 | 17% |
Unknown | 31 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 46 | 39% |
Biochemistry, Genetics and Molecular Biology | 11 | 9% |
Agricultural and Biological Sciences | 10 | 9% |
Nursing and Health Professions | 4 | 3% |
Veterinary Science and Veterinary Medicine | 3 | 3% |
Other | 9 | 8% |
Unknown | 34 | 29% |