Secondary hypertensive disorders - primary hyperaldosteronism
Description
- Autonomous aldosterone production independent of renin and angiotensin II
- Triad: hypertension + suppressed renin + inappropriately high aldosterone
- *Hypokalaemia is present in only ~30% - a normal potassium does not exclude it*
- The commonest surgically curable cause of hypertension, and the commonest secondary cause overall
Clinical
- Hypertension - often resistant, often early-onset
- Symptoms of hypokalaemia when present: polyuria, nocturia, polydipsia (hypokalaemic nephrogenic DI), cramps, weakness, tetany, arrhythmia
- Metabolic alkalosis; oedema is characteristically absent (aldosterone escape)
- *Aldosterone excess causes cardiovascular and renal damage out of proportion to the blood pressure* - LVH, AF, stroke, MI, albuminuria
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