RENAL ABNORMALITIES AND VASCULAR COMPLICATIONS IN PRIMARY HYPERALDOSTERONISM - EVIDENCE ON TERTIARY HYPERALDOSTERONISM

  • 1 January 1976
    • journal article
    • research article
    • Vol. 45  (179) , 401-410
Abstract
The frequency of underlying renal or renal artery disease and the incidence of vascular complications were reviewed in a series of 136 cases of [human] primary hyperaldosteronism. This was in order to investigate the possible existence of tertiary hyperaldosteronism, and to examine the commonly held view that primary hyperaldosteronism is a relatively benign form of hypertension. Ten cases (7.4%) had evidence of renal artery stenosis and 11 (8.1%) parenchymatous renal disease. In comparison with the reported frequency in large general series of hypertensives, these data show no evidence of an excess of underlying renal disease. It is unlikely, therefore, that autonomous aldosterone secreting adenomata occur commonly as a consequence of prolonged secondary hyperaldosteronism. Four cases (2.9%) had evidence of the malignant-phase of hypertension, and over a mean observation time of 5.9 yr, 31 cases (22.8%) developed 39 vascular complications. It appears, therefore, that vascular complications are not rare in primary hyperaldosteronism, and early and effective treatment is thus necessary.