Fundamental Elements to Take into Account for the Current Diagnosis of Primary Hyperaldosteronism
Keywords:
primary hyperaldosteronism, secondary hyperaldosteronism, diagnosis, arterial hypertension.Abstract
Introduction: Primary hyperaldosteronism is the most common cause of endocrine arterial hypertension and its diagnosis requires the indication and performance of several complementary tests. In Cuba, this topic has not been reviewed recently, so updating it would be useful.
Objective: To describe the fundamental elements to take into account for the current diagnosis of primary hyperaldosteronism.
Methods: To carry out the search for information, the period from August to September 2022 was taken into account. The keywords used were primary hyperaldosteronism; secondary hyperaldosteronism; diagnosis; and arterial hypertension, using Google Scholar, PubMed and SciELO databases. Different reviews, research works and Web pages were evaluated, which generally dated less than 10 years of publication in Spanish, Portuguese or English and, by their title, dealt with the topic of study. Articles that did not address the relationship between primary hyperaldosteronism and its diagnosis were excluded. Forty-four bibliographic references met the selection criteria.
Conclusions: In the presence of a clinical condition, suggestive of primary hyperaldosteronism, the plasma aldosterone/plasma renin activity ratio must be determined. If this is elevated, confirmatory functional tests will be performed and once the presence of the disease is verified, abdominal imaging techniques are performed to try to determine the cause and guide the therapeutic strategy. In case of doubt or in patients with criteria for surgery, catheterization of the adrenal veins should be performed.
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