Pacino62 wrote:exculpatory wrote:Newish concept coming into play - subject of excellent symposium at the annual meeting of the Endocrine Society in New Orleans I just attended: Primary hyperaldosteronism may account for as many as 15-20% of people with hypertension (vastly underdiagnosed) & is by far & away the leading cause of secondary hypertension. Also, primary hyperaldosteronism exists on a mild to severe clinical spectrum, & milder forms of hyperaldosteronism not readily diagnosed with currently accepted diagnostic criteria may account for a significant percentage of people with so called essential hypertension (what Dr. John Laragh @ Columbia labeled low renin essential hypertension more than 50 years ago.)
Ex...your medical posts literally confuse the **** out of me. Lmao. I’m no rocket scientist, but I’ve done ok for myself. However, I read these posts at least 10 times trying to see if I can decipher what the **** they are all about.
I usually have my IPad up while reading and my phone in hand searching words in Google. It’s a compliment by the way. Not busting your balls.
BOTTOMLINE:
1. There are a **** load of people with hypertension primarily the result of excess amounts of the adrenal mineralocorticoid hormone aldosterone.
2. The vast majority are not being diagnosed because 1) the current screening diagnostic criteria (including the aldosterone/renin ratio = ARR) are not being utilized by most of the primary care physicians caring for the tens & tens & tens of millions of people with hypertension; AND 2) the current screening diagnostic criteria “may” be too stringent to diagnose milder/earlier forms of the disease (see above). In other words, only patients at the very tip of the iceberg are being referred to endocrinologists after screening to lock in/confirm the diagnosis & then recommend appropriate therapy (medical including aldosterone antagonists like aldactone or eplerenone and/or in some cases surgical resection of an aldosterone producing adrenal adenoma).
Just google Primary Hyperaldosteronism or “aldosterone excess” if you want to better understand the rudiments.
If you want to get blown away, try scanning through this.
er.2018-00139.pdf
I spoke at length with the lead author (Anand Vaidya from the Brigham/Harvard) after his presentation - a very very smart dude making a very very important contribution.
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