Primary hyperaldosteronism: existing problems and possible solutions

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Abstract

Primary hyperaldosteronism (PHA) as the most common cause of secondary arterial hypertension (AH), and accounts for 10–15% of cases according to the literature. However, the true prevalence of PHA is underestimated due to the lack of clear, understandable diagnostic algorithms for primary care physicians and incorrect interpretation of results. This is especially true for “mild” forms of the disease. Despite the lack of a clear clinical picture, PHA is associated with a higher risk of adverse cardiovascular events and metabolic disorders compared with essential AH, even when blood pressure target levels are achieved. Understanding the new pathogenetic aspects of PHA, in particular the connection between the clinical form of the disease and somatic mutations of ion channels that accumulate with age, is intended to make the diagnosis of PHA more convenient for everyday clinical practice and, thus, increase the effectiveness of treatment and the quality of life of patients.

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About the authors

D. O. Ladygina

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: d8050005@gmail.com
ORCID iD: 0000-0001-6418-7060
SPIN-code: 7958-9435

Cand. Sci. (Med.), Associate Professor, Department of Endocrinology № 1, Institute of Clinical Medicine n.a. N.V. Sklifosovsky

Russian Federation, Moscow

A. A. Vastistova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: d8050005@gmail.com
ORCID iD: 0009-0005-9587-8370
Russian Federation, Moscow

E. S. Shilenkova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: d8050005@gmail.com
ORCID iD: 0009-0004-5109-5027
Russian Federation, Moscow

N. M. Platonova

Endocrinology Research Centre

Email: d8050005@gmail.com
ORCID iD: 0000-0001-6388-1544
SPIN-code: 4053-3033
Russian Federation, Moscow

D. G. Beltsevich

Endocrinology Research Centre

Email: d8050005@gmail.com
ORCID iD: 0000-0001-7098-4584
SPIN-code: 4475-6327
Russian Federation, Moscow

V. V. Fadeev

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: d8050005@gmail.com
ORCID iD: 0000-0002-3026-6315
SPIN-code: 6825-8417
Russian Federation, Moscow

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2. Fig. 1. Reason for examination, during which PHA was diagnosed, % (Source: D.O. Ladygina et al.)

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3. Fig. 2. Degree of AH, %

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