Purpose of Review

Primary aldosteronism (PA) is the most common cause of secondary hypertension. Emerging evidence suggests that PA is associated with cardiovascular, metabolic, and renal complications, that likely develop insidiously, due to prolonged inappropriate mineralocorticoid receptor activation. In this review, we discuss the expanding clinical and pathological spectrum of PA.

Recent Findings

Clinical and molecular studies conducted over the recent years reveal that PA traverses a series of contiguous stages. Pre-clinical, but hormonally overt PA has been identified in patients with normal blood pressure, and such patients harbor an increased risk of developing hypertension. Similarly, genetic and histopathological advancements have exposed a spectrum of PA pathology that corresponds to a continuum that spans from pre-clinical stages to florid PA.

Summary

PA evolves from pre-hypertensive stages to resistant hypertension, along with serious cardiovascular and renal consequences. Early recognition of PA and targeted therapy will be essential for cardiovascular morbidity and mortality prevention in a large number of patients.

中文翻译：

---

原发性醛固酮增多症：从正常血压到高血压的连续过程

审查目的

原发性醛固酮增多症 (PA) 是继发性高血压的最常见原因。新出现的证据表明 PA 与心血管、代谢和肾脏并发症有关，这些并发症很可能是由于长期不适当的盐皮质激素受体激活而隐匿性发展的。在这篇综述中，我们讨论了 PA 不断扩大的临床和病理范围。

最近的发现

近年来进行的临床和分子研究表明，PA 跨越一系列连续的阶段。已经在血压正常的患者中发现了临床前但荷尔蒙明显的 PA，这些患者患高血压的风险增加。同样，遗传和组织病理学的进步暴露了一系列 PA 病理学，对应于从临床前阶段到华丽 PA 的连续统一体。

概括

PA 从高血压前期发展到顽固性高血压，伴随着严重的心血管和肾脏后果。早期识别 PA 和靶向治疗对于大量患者的心血管发病率和死亡率预防至关重要。