Primary Aldosteronism Mutations, Mechanisms, Prevalence, and Public Health


The first section (mutations) will address the (relatively) novel data on mutations causing hyperaldosteronism. The second section (mechanisms) will cover perhaps the least well-understood facet of PA, the genesis of the well-described heightened cardiovascular risk. The third section deals with clinical issues—prevalence, recognition, referrals, and the necessity to recognize PA as a major public health problem. The take home messages are 4-fold: that somatic mutations in the adrenal cortex account for most but not (yet?) all cases of unilateral PA and possibly bilateral PA; that familial PA reflects a variety of germline mutations, but is relatively rare; that how elevated aldosterone levels for sodium status causes increased cardiovascular risk remains unknown; and finally, that PA represents a major and hitherto unrecognized public health problem.

Authors: John W. Funder
Keywords: somatic mutations, germ line mutations, prevalence, public health, cardiovascular risk, ACTH
DOI Number: 10.1161/HYPERTENSIONAHA.119.12935      Publication Year: 2019

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