Endocrine Abstracts

Aldosterone (Aldo) plays a crucial role in heart remodeling. 1) In presence of high sodium, Aldo induces fibrosis in the cardiovascular system by still partly unknown mechanisms. Aldo-salt induces a pericoronary inflammatory phenotype, that may be one of the first events leading to fibrosis. The RALES trial has evidenced a beneficial effect of spironolactone on both mortality and morbidity in heart failure (HF), that are linked to a reduction of cardiac fibrosis. 2) In rat hea...

A greater understanding of mineralocorticoid hormone action in recent years has facilitated the elucidation of the molecular basis of several 'salt-wasting' and 'salt-retaining' disorders.In mineralocorticoid-responsive salt transporting epithelial cells of the distal nephron, colon and salivary gland, aldosterone or, depending upon the activity of 11beta hydroxysteroid dehydrogenase type 2 (11beta HSD2), cortisol, interacts with the mineralocorticoid re...

Primary Aldosteronism (PA), as defined by the autonomous and inappropriate secretion of aldosterone, causes mineralocorticoid hypertension. Key features of this include suppression of plasma renin and hypokalaemia. Recent studies that have used the ratio of aldosterone to renin (ARR) as a screening test have suggested that the prevalence of PA in unselected populations of patients with hypertension is around 10%. Only a minority of these patients, however, have a low potassium...

The diagnosis of primary aldosteronism results in either the surgical cure of hypertension or targeted pharmacotherapy. The two major subtypes of primary aldosteronism are unilateral aldosterone-producing adenoma (APA) and bilateral idiopathic hyperplasia (IHA). Patients with APA are usually treated with unilateral adrenalectomy, and patients with IHA are treated medically. Most patients with primary aldosteronism have IHA and require pharmacotherapy. Because of the recent rec...