Willenberg Holger S
Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany.
Horm Metab Res. 2017 Mar;49(3):151-163. doi: 10.1055/s-0043-100767. Epub 2017 Mar 28.
The last years have seen substantial progress in primary aldosteronism (PA), which is the most common cause of secondary hypertension. Many programs have been established around the world to meet the needs in healthcare and the management of patients with PA according to published guidelines and clinical protocols. Systematic analysis of emerging data and meticulous scientific work have informed us on the molecular basis of the disease and helped to characterize hereditary forms of PA. Techniques have been developed to better diagnose PA and to establish genotype-phenotype relationships and their impact on hypertension. Studies have been undertaken to stratify patients for risk factors and to ensure quality of best medical treatment. This review focuses on some clinically relevant problems in characterizing autonomous aldosterone secretion and discusses testing and management strategies. Besides, this review puts the emphasis on some colorful studies not to pale soon beside an ever evolving painting background.
过去几年,原发性醛固酮增多症(PA)取得了重大进展,PA是继发性高血压最常见的病因。世界各地已建立了许多项目,以满足医疗保健需求,并根据已发表的指南和临床方案对PA患者进行管理。对新出现数据的系统分析和细致的科学研究让我们了解了该疾病的分子基础,并有助于明确PA的遗传形式。已开发出一些技术,以更好地诊断PA,并建立基因型与表型的关系及其对高血压的影响。已开展研究对患者的风险因素进行分层,并确保最佳药物治疗的质量。本综述重点关注在特征性自主醛固酮分泌方面的一些临床相关问题,并讨论检测和管理策略。此外,本综述强调了一些引人注目的研究,以免在不断变化的背景下很快黯然失色。