Endocrine Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia.
Endocrine. 2012 Feb;41(1):31-9. doi: 10.1007/s12020-011-9553-3. Epub 2011 Nov 1.
Primary aldosteronism is now thought to be the commonest potentially curable and specifically treatable form of hypertension. The detection of primary aldosteronism is of utmost importance not only because it provides an opportunity for a targeted treatment, but also because it has been demonstrated that patients with primary aldosteronism are more prone to cardiovascular events and target organ damage than essential hypertensives. Normalization of blood pressure and hypokalemia should not be the only goal of treatment. Normalization of circulating aldosterone or mineralocorticoid blockade is necessary to prevent aldosterone-induced tissue damage that occurs independent of blood pressure. This review will focus on the current understanding and comprehensive management review of primary aldosteronism, highlighting the new evidence that has become recently available.
原发性醛固酮增多症现在被认为是最常见的潜在可治愈和特定可治疗的高血压类型。检测原发性醛固酮增多症非常重要,不仅因为它提供了一个有针对性的治疗机会,还因为已经证明原发性醛固酮增多症患者比原发性高血压患者更容易发生心血管事件和靶器官损伤。血压和低钾血症的正常化不应该是治疗的唯一目标。需要使循环醛固酮或盐皮质激素阻断正常化,以防止独立于血压发生的醛固酮引起的组织损伤。本综述将重点介绍目前对原发性醛固酮增多症的理解和全面管理综述,突出最近获得的新证据。