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Approach to the patient with hypertension and hypokalemia

INTRODUCTION

Nonsuppressible (primary) hypersecretion of aldosterone is an underdiagnosed cause of hypertension. The classic presenting signs of primary aldosteronism are hypertension and hypokalemia. The most common subtypes of primary aldosteronism are:

  • Aldosterone-producing adenomas
  • Bilateral idiopathic hyperaldosteronism (bilateral adrenal hyperplasia)

Less common forms include:

  • Familial hyperaldosteronism type I (glucocorticoid-remediable aldosteronism) and type II (the familial occurrence of aldosterone-producing adenoma or bilateral idiopathic hyperplasia or both) (see "Familial hyperaldosteronism" and 'Genetic testing' below)
  • Pure aldosterone-producing adrenocortical carcinomas
  • Ectopic aldosterone-producing tumors

The diagnosis of primary aldosteronism will be reviewed here. The clinical manifestations and treatment of this disorder are discussed separately. (See "Clinical features of primary aldosteronism" and "Treatment of primary aldosteronism".)

                           

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Literature review current through: Mar 2014. | This topic last updated: Mar 12, 2013.
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