Interaction between primary hyperaldosteronism and blood pressure regulation

Authors

Keywords:

ENFERMEDADES CARDIOVASCULARES; HIPERALDOSTERONISMO; HIPERTENSIÓN., CARDIOVASCULAR DISEASES; HYPERALDOSTERONISM; HYPERTENSION., DOENÇAS CARDIOVASCULARES; HIPERALDOSTERONISMO; HIPERTENSÃO.

Abstract

Introduction: primary hyperaldosteronism (PA) is the most common endocrine cause of secondary hypertension, with significant implications for cardiovascular and renal risk.

Objective: to evaluate the interaction between primary hyperaldosteronism and blood pressure regulation.

Methods: a documentary review was conducted using meta-search engines such as Epistemonikos and Tripdatabase, as well as databases including Medline, Scopus, and Cochrane. MeSH terms related to hyperaldosteronism, hypertension, and pathophysiology were applied. Studies published between 2018 and 2023 were included, prioritizing systematic reviews, clinical guidelines, and meta-analyses. Outdated or scientifically unsound works were excluded. Analysis was performed through critical synthesis of diagnostic algorithms and therapeutic strategies.

Development: primary hyperaldosteronism is characterized by autonomous aldosterone secretion, renin suppression, and sodium retention. Its prevalence ranges from 5 % to 20 % among hypertensive patients, and is higher in resistant cases. Main subtypes include aldosterone-producing adenoma and bilateral adrenal hyperplasia. Diagnosis relies on the aldosterone-to-renin ratio (ARR), confirmatory tests, and imaging or adrenal venous sampling. Treatment includes laparoscopic adrenalectomy for unilateral forms and mineralocorticoid receptor antagonists for bilateral cases. Evidence shows that timely intervention reduces cardiovascular, metabolic, and renal complications.

Conclusions: primary hyperaldosteronism is a curable but underdiagnosed cause of hypertension. Early detection and subtype differentiation are essential to guide effective therapies. Appropriate management improves blood pressure control and reduces cardiovascular and metabolic risks, providing a solid foundation to optimize clinical practice and patient quality of life.

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References

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Published

2025-12-31

How to Cite

1.
López Barrionuevo CG, Salazar-Pullutacsi KD, Villacis-Paredes GA. Interaction between primary hyperaldosteronism and blood pressure regulation. Rev Ciencias Médicas [Internet]. 2025 Dec. 31 [cited 2026 Feb. 13];29(supl2):e7041. Available from: https://revcmpinar.sld.cu/index.php/publicaciones/article/view/7041

Issue

Vol. 29 No. supl2 (2025): Suplemento 2

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REVIEW ARTICLES

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Copyright (c) 2026 Carlos Gustavo López Barrionuevo

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