Diagnosis and Treatment of Unilateral Forms of Primary Aldosteronism
Primary aldosteronism (PA) is now recognized as the most frequent form of secondary arterial hypertension.
The importance of a correct and prompt diagnosis of PA is determined by its relevant prevalence, its increased
cardiovascular risk compared to essential hypertension and by the possibility of reversing this increased risk with a
targeted therapy. Surgical treatment of unilateral forms of PA (mainly aldosterone-producing adenomas) is at present
recommended in well-selected patients because of its cost-effectiveness. Therefore, subtype differentiation of PA forms is
of fundamental importance, and available guidelines recommend contrast-enhanced CT-scanning and adrenal venous
sampling (AVS) as the main diagnostic tests for this purpose. In this review, we discuss the value of adrenal non-invasive
imaging and AVS, the recent advances in complementary tests and, finally, the available data on the outcome of surgical
treatment for PA.
Keywords: Adrenal vein sampling, aldosterone, aldosterone-producing adenoma, familial hyperaldosteronism, endocrine
hypertension, primary aldosteronism.
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