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Submitted: 05 June 2017 Modified: 06 June 2017
HERDIN Record #: R04A-UPHBL-17060511554956

PRIMARY HYPERALDOSTERONISM.

1Ray Albert P. Cabigan,
2Elaine Gayle P. Lopez,
3Ma. Rhodora D. Valenzona
Department of Internal Medicine - UPH-Dr. Jose G. Tamayo Medical University,
Internal Medicine-Endocrinologist - UPH-Dr. Jose G. Tamayo Medical University,
Internal Medicine-Nephrologist - UPH-Dr. Jose G. Tamayo Medical University
1.
Publication Type:
Annual Report
Title:
UPH-Dr. Jose G. Tamayo Medical University/Medical Center
Date:
2013
Page(s):
73-90
Publisher:
UPH-Dr. Jose G. Tamayo Medical University/Medical Center

Objectives

Hypertension among adolescents is slowly becoming a common disease entity. Secondary hypertension is a common cause of elevated blood pressure in the young. Among the common yet overlooked causes of hypertension in the young, is hyperaldosteronism . Objectives. This paper will discuss the differential diagnosis of hypertension in the young and subsequently introc methods in identifying primary hyperaldosteronism, its management prognosis and outcomes of treatment. Case.Such is the case of a 20 year old male who came in with a chief complaint for long standing hypertension 140/90-150/90 mmHg. patient underwent blood chemistry, ECG, Chest X-ray, Abdominal Ultrasound, and Abdominal MRI, all of which revealed normal findings. Aldosterone-Renin-Ratio (ARR) however was found to be 45.5. An ARR value of >20 is highly suggestive of hyperaldosteronism. He was maintained on Amlodipine 5mg/tab, OD, but due to persistence of elevated blood pressure he sought consult in our institutio. Ohysical examination findings were normal except for the blood pressure of 140/90 mmHg. Diagnostics. Upper abdominal CT Scan with contrast revealed of any masses. Saline suppression test was done, revealing a post saline loading serum aldosterone of 30 ng/mL confirming the roprimary hyperaldosteronism (A post saline aldosterone of >10 ng/mL is diagnostic of primary hyperaldosteronism). Therapeutics/Outcome. The patient was started on spironolactone 50 mg/tab 1 tablet BID and at present, the blood pressure has been maintained from 120/80 mmHg to 130-90 mmHg

LocationCall NumberAvailable FormatAvailability
UPH-Dr. Jose G. Tamayo Medical University/Medical Center Abstract Print Format
1. Catena, C. . "Long-Term Cardiac Effects of Adrenalectomy of Mineralocorticoid Antagonists in patients with primary Aldosteronism" AHA, Hypertension 50, 911-8, 2007-2007
2. Chaudry, M. , Said, S. . "Case Report: A Patient with Primary Aldsoteronism" Hospital Physician , 2004-2004
3. Fauci, R. , Taglioni, C. . "Changes in the perceived epidemiology of primary hyperaldosteronism" International Journal of Hypertension , 2001-2001
4. Fogari, R. . "Prevalence of primary aldosteronism among unselected hypertensive patients: a prospective study based on the use of an alosterone / renin ration above 25 screening test." Hypertensive Research 30(2): 111-117, 2007-2007
5. Funder, J. . "Case detection, diagnosis and treatment of patients with primary aldosteronism: An endocrine society Clinical Practice Guideline. Endocrine Society" Journal of Clinical Endocrinology and Metabolism , 2008-2008
6. Garovic, V. , Kane, G. , Schwartz, G. . "Renovascular hypertension: Balancing the controversies in diagnosis and treatment" Cleveland Clinic Journal of Medicine 72(12): 1135-1147 , 2005-2005