medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-270medsovet-7785Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯARTERIAL HYPERTENSIONПроблемы диагностики вторичных артериальных гипертензий надпочечникового генезаProblems in the diagnosis of secondary arterial hypertension of adrenal originhttps://orcid.org/0000-0001-8827-4919ШароноваЛ. А.SharonovaL. A.

Шаронова Людмила Александровна - кандидат медицинских наук, доцент кафедры эндокринологии и гериатрии.

443099, Самара, ул. Чапаевская, д. 89

Lyudmila A. Sharonova - Cand. Sci. (Med.), Associate Professor of the Department of Endocrinology and Geriatrics.

89, Chapaevskaya St., Samara, 443099

l.a.sharonova@samsmu.ruhttps://orcid.org/0000-0003-0027-1786БулгаковаС. В.BulgakovaS. V.

Булгакова Светлана Викторовна - доктор медицинских наук, доцент, заведующий кафедрой эндокринологии и гериатрии.

443099, Самара, ул. Чапаевская, д. 89

Svetlana V. Bulgakova - Dr. Sci. (Med.), Associate Professor, Head of the Department of Endocrinology and Geriatrics.

89, Chapaevskaya St., Samara, 443099

osteoporosis63@gmail.comhttps://orcid.org/0000-0001-6678-6411ДолгихЮ. А.DolgikhYu. A.

Долгих Юлия Александровна - кандидат медицинских наук, ассистент кафедры эндокринологии и гериатрии.

443099, Самара, ул. Чапаевская, д. 89

Yulia A. Dolgikh - Cand. Sci. (Med.), Assistant of the Department of Endocrinology and Geriatrics.

89, Chapaevskaya St., Samara, 443099

yu.a.dolgikh@samsmu.ruhttps://orcid.org/0000-0002-5754-1057КосареваО. В.KosarevaO. V.

Косарева Ольга Владиславовна - кандидат медицинских наук, доцент кафедры эндокринологии и гериатрии.

443099, Самара, ул. Чапаевская, д. 89

Olga V. Kosareva - Cand. Sci. (Med.), Associate Professor of the Department of Endocrinology and Geriatrics.

89, Chapaevskaya St., Samara, 443099

o.v.kosareva@samsmu.ruСамарский государственный медицинский университетРоссияSamara State Medical UniversityRussian Federation2023201020230162331Copyright © Шаронова Л.А., Булгакова С.В., Долгих Ю.А., Косарева О.В., 20232023Шаронова Л.А., Булгакова С.В., Долгих Ю.А., Косарева О.В.Sharonova L.A., Bulgakova S.V., Dolgikh Y.A., Kosareva O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7785

Первичный гиперальдостеронизм (ПГА) является ведущей причиной вторичной артериальной гипертензии надпочечникового генеза. Его распространенность недооценивается, что приводит к поздней диагностике, хотя своевременно поставленный диагноз позволяет достичь полного излечения пациента или обеспечить контроль артериального давления и избежать развития осложнений. В статье обсуждается распространенность ПГА, его этиология и патогенез, механизмы формирования автономной секреции альдостерона, в том числе с сочетанной продукцией кортизола. Дается оценка основным клиническим эффектам гиперсекреции альдостерона, а также его роли в формировании осложнений со стороны сердечно-сосудистой системы и метаболического контроля. Авторы указывают на группы риска, в которых должен проводиться скрининг, а также на этапы диагностического поиска при подозрении на ПГА. Для проведения первичного теста необходима предварительная оценка уровня калия плазмы и при выявлении гипокалиемии – ее коррекция. Перевод пациентов на антигипертензивные препараты с минимальным влиянием на ренин-ангиотензинальдостероновую систему осуществляется только в случае получения ложноотрицательного первичного теста и необходимости повторного тестирования. При проведении подтверждающего теста важно помнить, что тесты с натриевой нагрузкой могут быть противопоказаны ряду пациентов. Компьютерная томография с контрастированием в сочетании с проведением селективного венозного забора крови является наиболее значимым методом топической диагностики ПГА и играет решающую роль в выборе метода лечения.

Primary hyperaldosteronism is the leading cause of secondary arterial hypertension of adrenal origin. Its prevalence is underestimated. This leads to late diagnosis, although a timely diagnosis can achieve a complete cure for the patient, ensure control of blood pressure and avoid the development of complications. The article discusses the prevalence of primary hyperaldosteronism, its etiology and pathogenesis, the mechanisms of formation of autonomous secretion of aldosterone, including with the combined production of cortisol. The main clinical effects of aldosterone hypersecretion, its role in the formation of complications in the cardiovascular system and metabolic control are discussed. The assessment of the main clinical effects of aldosterone hypersecretion and its role in the formation of complications from the cardiovascular system and metabolic control is given. The authors remind about risk groups in which screening should be carried out, about the stages of a diagnostic search for suspected primary hyperaldosteronism. For the primary test, a preliminary assessment of the level of plasma potassium is necessary, and if hypokalemia is detected, its correction. If the result of the primary test is false negative, retesting will be carried out with the transfer of patients to antihypertensive drugs with minimal effect on the renin-angiotensinaldosterone system. It is important to remember that confirmatory sodium loading tests are contraindicated in some patients. Computed tomography with contrast in combination with selective venous blood sampling in patients are the most significant methods for the topical diagnosis of primary hyperaldosteronism. The choice of treatment method and its effectiveness depend on their results.

заболевания надпочечниковальдостеронпервичный гиперальдостеронизмдиагностика гиперальдостеронизмакомпьютерная томографияселективный венозный забор кровиadrenal gland diseasesaldosteroneprimary hyperaldosteronismdiagnosis of hyperaldosteronismcomputed tomographyadrenal vein samplingReferencesМуромцева ГА, Концевая АВ, Константинов ВВ, Артамонова ГВ, Гатагонова ТМ, Дупляков ДВ и др. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012–2013 гг. результаты исследования ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2014;13(6):4–11. https://doi.org/10.15829/1728-8800-2014-6-4-11.Muromtseva GA, Kontsevaya AV, Konstantinov VV, Artamonova GV, Gatagonova TM, Duplyakov DV et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012–2013 years. The results of ECVD-RF. Cardiovascular Therapy and Prevention. 2014;13(6):4–11. (In Russ.) https://doi.org/10.15829/1728-8800-2014-6-4-11.Концевая АВ, Шальнова СА, Драпкина ОМ. Исследование ЭССЕ-РФ: эпидемиология и укрепление общественного здоровья. Кардиоваскулярная терапия и профилактика. 2021;20(5):2987. https://doi.org/10.15829/1728-8800-2021-2987.Kontsevaya AV, Shalnova SA, Drapkina OM. ESSE-RF study: epidemiology and public health promotion. Cardiovascular Therapy and Prevention. 2021;20(5):2987. (In Russ.) https://doi.org/10.15829/1728-8800-2021-2987.Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35(19):1245–1254. https://doi.org/10.1093/eurheartj/eht534.Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35(19):1245–1254. https://doi.org/10.1093/eurheartj/eht534.Юкина МЮ, Трошина ЕА, Бельцевич ДГ, Платонова НМ. Вторичная (эндокринная) артериальная гипертензия: лекция для врачей. Альманах клинической медицины. 2016;44(4):501–512. https://doi.org/10.18786/2072-0505-2016-44-4-501-512.Yukina MYu, Troshina EA, Beltsevich DG, Platonova NM. Secondary (endocrine) hypertension: lecture. Almanac of Clinical Medicine. 2016;44(4):501–512. (In Russ.) https://doi.org/10.18786/2072-0505-2016-44-4-501-512.Rossi GP, Bisogni V, Rossitto G, Maiolino G, Cesari M, Zhu R, Seccia TM. Practice Recommendations for Diagnosis and Treatment of the Most Common Forms of Secondary Hypertension. High Blood Press Cardiovasc Prev. 2020;27(6):547–560. https://doi.org/10.1007/s40292-020-00415-9.Rossi GP, Bisogni V, Rossitto G, Maiolino G, Cesari M, Zhu R, Seccia TM. Practice Recommendations for Diagnosis and Treatment of the Most Common Forms of Secondary Hypertension. High Blood Press Cardiovasc Prev. 2020;27(6):547–560. https://doi.org/10.1007/s40292-020-00415-9.Калягин АН, Белобородов ВА, Максикова ТМ. Симптоматическая артериальная гипертензия на фоне первичного гиперальдостеронизма. Артериальная гипертензия. 2017;23(3):224–230. https://doi.org/10.18705/1607-419X-2017-23-3-224-230.Kalyagin AN, Beloborodov VA, Maksikova TM. Symptomatic arterial hypertension associated with primary hyperaldosteronism. Arterial Hypertension. 2017;23(3):224–230. (In Russ.) https://doi.org/10.18705/1607-419X-2017-23-3-224-230.Rossi GP, Bisogni V, Bacca AV, Belfiore A, Cesari M, Concistrè A et al. The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism. Int J Cardiol Hypertens. 2020;5:100029. https://doi.org/10.1016/j.ijchy.2020.100029.Rossi GP, Bisogni V, Bacca AV, Belfiore A, Cesari M, Concistrè A et al. The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism. Int J Cardiol Hypertens. 2020;5:100029. https://doi.org/10.1016/j.ijchy.2020.100029.Meng Z, Zhou L, Dai Z, Xu C, Qian G, Peng M et al. The Quality of Clinical Practice Guidelines and Consensuses on the Management of Primary Aldosteronism: A Critical Appraisal. Front Med (Lausanne). 2020;7:136. https://doi.org/10.3389/fmed.2020.00136.Meng Z, Zhou L, Dai Z, Xu C, Qian G, Peng M et al. The Quality of Clinical Practice Guidelines and Consensuses on the Management of Primary Aldosteronism: A Critical Appraisal. Front Med (Lausanne). 2020;7:136. https://doi.org/10.3389/fmed.2020.00136.Hundemer GL, Kline GA, Leung AA. How common is primary aldosteronism? Curr Opin Nephrol Hypertens. 2021;30(3):353–360. https://doi.org/10.1097/MNH.0000000000000702.Hundemer GL, Kline GA, Leung AA. How common is primary aldosteronism? Curr Opin Nephrol Hypertens. 2021;30(3):353–360. https://doi.org/10.1097/MNH.0000000000000702.Dutta RK, Söderkvist P, Gimm O. Genetics of primary hyperaldosteronism. Endocr Relat Cancer. 2016;23(10):R437–454. https://doi.org/10.1530/ERC-16-0055.Dutta RK, Söderkvist P, Gimm O. Genetics of primary hyperaldosteronism. Endocr Relat Cancer. 2016;23(10):R437–454. https://doi.org/10.1530/ERC-16-0055.Armanini D, Andrisani A, Donà G, Bordin L, Ambrosini G, Sabbadin C. Hypothesis on a relationship between hyperaldosteronism, inflammation, somatic mutations, and autoimmunity. J Clin Hypertens (Greenwich). 2017;19(11):1060–1062. https://doi.org/10.1111/jch.13074.Armanini D, Andrisani A, Donà G, Bordin L, Ambrosini G, Sabbadin C. Hypothesis on a relationship between hyperaldosteronism, inflammation, somatic mutations, and autoimmunity. J Clin Hypertens (Greenwich). 2017;19(11):1060–1062. https://doi.org/10.1111/jch.13074.Armanini D, Fiore C, Pellati D. Spontaneous resolution of idiopathic aldosteronism after long-term treatment with potassium canrenoate. Hypertension. 2007;50(4):e69–70. https://doi.org/10.1161/HYPERTENSIONAHA.107.096925.Armanini D, Fiore C, Pellati D. Spontaneous resolution of idiopathic aldosteronism after long-term treatment with potassium canrenoate. Hypertension. 2007;50(4):e69–70. https://doi.org/10.1161/HYPERTENSIONAHA.107.096925.Nanba K, Rainey WE. Genetics in endocrinology: Impact of race and sex on genetic causes of aldosterone-producing adenomas. Eur J Endocrinol. 2021;185(1):R1–R11. https://doi.org/10.1161/10.1530/EJE-21-0031.Nanba K, Rainey WE. Genetics in endocrinology: Impact of race and sex on genetic causes of aldosterone-producing adenomas. Eur J Endocrinol. 2021;185(1):R1–R11. https://doi.org/10.1161/10.1530/EJE-21-0031.Fernandes-Rosa FL, Williams TA, Riester A, Steichen O, Beuschlein F, Boulkroun S et al. Genetic spectrum and clinical correlates of somatic mutations in aldosterone-producing adenoma. Hypertension. 2014;64(2):354–361. https://doi.org/10.1161/HYPERTENSIONAHA.114.03419.Fernandes-Rosa FL, Williams TA, Riester A, Steichen O, Beuschlein F, Boulkroun S et al. Genetic spectrum and clinical correlates of somatic mutations in aldosterone-producing adenoma. Hypertension. 2014;64(2):354–361. https://doi.org/10.1161/HYPERTENSIONAHA.114.03419.Azizan EA, Poulsen H, Tuluc P, Zhou J, Clausen MV, Lieb A et al. Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension. Nat Genet. 2013;45(9):1055–1060. https://doi.org/10.1038/ng.2716.Azizan EA, Poulsen H, Tuluc P, Zhou J, Clausen MV, Lieb A et al. Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension. Nat Genet. 2013;45(9):1055–1060. https://doi.org/10.1038/ng.2716.Tauber P, Aichinger B, Christ C, Stindl J, Rhayem Y, Beuschlein F et al. Cellular Pathophysiology of an Adrenal Adenoma-Associated Mutant of the Plasma Membrane Ca(2+)-ATPase ATP2B3. Endocrinology. 2016;157(6):2489–2499. https://doi.org/10.1210/en.2015-2029.Tauber P, Aichinger B, Christ C, Stindl J, Rhayem Y, Beuschlein F et al. Cellular Pathophysiology of an Adrenal Adenoma-Associated Mutant of the Plasma Membrane Ca(2+)-ATPase ATP2B3. Endocrinology. 2016;157(6):2489–2499. https://doi.org/10.1210/en.2015-2029.Scholl UI. Genetics of Primary Aldosteronism. Hypertension. 2022;79(5): 887–897. https://doi.org/10.1161/HYPERTENSIONAHA.121.16498.Scholl UI. Genetics of Primary Aldosteronism. Hypertension. 2022;79(5): 887–897. https://doi.org/10.1161/HYPERTENSIONAHA.121.16498.Williams TA, Gomez-Sanchez CE, Rainey WE, Giordano TJ, Lam AK, Marker A, Mete O et al. International histopathology consensus for unilateral primary aldosteronism. J Clin Endocrinol Metab. 2021;106:42–54. https://doi.org/10.1210/clinem/dgaa484.Williams TA, Gomez-Sanchez CE, Rainey WE, Giordano TJ, Lam AK, Marker A, Mete O et al. International histopathology consensus for unilateral primary aldosteronism. J Clin Endocrinol Metab. 2021;106:42–54. https://doi.org/10.1210/clinem/dgaa484.Mulatero P, Burrello J, Williams TA, Monticone S. Primary Aldosteronism in the Elderly. J Clin Endocrinol Metab. 2020;105(7):dgaa206. https://doi.org/10.1210/clinem/dgaa206.Mulatero P, Burrello J, Williams TA, Monticone S. Primary Aldosteronism in the Elderly. J Clin Endocrinol Metab. 2020;105(7):dgaa206. https://doi.org/10.1210/clinem/dgaa206.Nishimoto K, Tomlins SA, Kuick R, Cani AK, Giordano TJ, Hovelson DH et al. Aldosterone-stimulating somatic gene mutations are common in normal adrenal glands. Proc Natl Acad Sci U S A. 2015;112:E4591–E4599. https://doi.org/10.1073/pnas.1505529112.Nishimoto K, Tomlins SA, Kuick R, Cani AK, Giordano TJ, Hovelson DH et al. Aldosterone-stimulating somatic gene mutations are common in normal adrenal glands. Proc Natl Acad Sci U S A. 2015;112:E4591–E4599. https://doi.org/10.1073/pnas.1505529112.Yamazaki Y, Nakamura Y, Omata K, Ise K, Tezuka Y, Ono Y et al. Histopathological classification of cross-sectional image-negative hyperaldosteronism. J Clin Endocrinol Metab. 2017;102:1182–1192. https://doi.org/10.1210/jc.2016-2986.Yamazaki Y, Nakamura Y, Omata K, Ise K, Tezuka Y, Ono Y et al. Histopathological classification of cross-sectional image-negative hyperaldosteronism. J Clin Endocrinol Metab. 2017;102:1182–1192. https://doi.org/10.1210/jc.2016-2986.Rhayem Y, Perez-Rivas LG, Dietz A, Bathon K, Gebhard C, Riester A et al. PRKACA somatic mutations are rare findings in aldosterone-producing adenomas. J Clin Endocrinol Metab. 2016;101:3010–3017. https://doi.org/10.1210/jc.2016-1700.Rhayem Y, Perez-Rivas LG, Dietz A, Bathon K, Gebhard C, Riester A et al. PRKACA somatic mutations are rare findings in aldosterone-producing adenomas. J Clin Endocrinol Metab. 2016;101:3010–3017. https://doi.org/10.1210/jc.2016-1700.Sun N, Meyer LS, Feuchtinger A, Kunzke T, Knösel T, Reincke M et al. Mass spectrometry imaging establishes 2 distinct metabolic phenotypes of aldosterone-producing cell clusters in primary aldosteronism. Hypertension. 2020;75(3):634–644. https://doi.org/10.1161/HYPERTENSIONAHA.119.14041.Sun N, Meyer LS, Feuchtinger A, Kunzke T, Knösel T, Reincke M et al. Mass spectrometry imaging establishes 2 distinct metabolic phenotypes of aldosterone-producing cell clusters in primary aldosteronism. Hypertension. 2020;75(3):634–644. https://doi.org/10.1161/HYPERTENSIONAHA.119.14041.Monticone S, Castellano I, Versace K, Lucatello B, Veglio F, GomezSanchez CE et al. Immunohistochemical, genetic and clinical characterization of sporadic aldosteroneproducing adenomas. Mol Cell Endocrinol. 2015;411:146–154. https://doi.org/10.1016/j.mce.2015.04.022.Monticone S, Castellano I, Versace K, Lucatello B, Veglio F, GomezSanchez CE et al. Immunohistochemical, genetic and clinical characterization of sporadic aldosteroneproducing adenomas. Mol Cell Endocrinol. 2015;411:146–154. https://doi.org/10.1016/j.mce.2015.04.022.Tang L, Li X, Wang B, Ma X, Li H, Gao Y et al. Clinical Characteristics of Aldosteroneand Cortisol-Coproducing Adrenal Adenoma in Primary Aldosteronism. Int J Endocrinol. 2018:4920841. https://doi.org/10.1155/2018/4920841.Tang L, Li X, Wang B, Ma X, Li H, Gao Y et al. Clinical Characteristics of Aldosteroneand Cortisol-Coproducing Adrenal Adenoma in Primary Aldosteronism. Int J Endocrinol. 2018:4920841. https://doi.org/10.1155/2018/4920841.Шифман БМ, Платонова НМ, Молашенко НВ, Трошина ЕА, Романова НЮ, Колесникова ГС. Опухоли надпочечника с сочетанной секрецией альдостерона и кортизола – непростая сумма знакомых слагаемых (обзор литературы). Проблемы эндокринологии. 2019;65(2):113–123. https://doi.org/10.14341/probl10036. Shifman BM, Platonova NM, Molashenko NV, Troshina EA,Romanova NYu, Kolesnikova GS. Aldosteroneand cortisol-co-secreting adrenal tumors: an uneasy sum of well-known parts (review). Problems of Endocrinology. 2019;65(2):113–123. (In Russ.) https://doi.org/10.14341/probl10036.Nakamura Y, Kitada M, Satoh F, Maekawa T, Morimoto R, Yamazaki Y et al. Intratumoral heterogeneity of steroidogenesis in aldosteroneproducing adenoma revealed by intensive double and tripleimmunostaining for CYP11B2/B1 and CYP17. Mol Cell Endocrinol. 2016;422:57–63. https://doi.org/10.1016/j.mce.2015.11.014.Nakamura Y, Kitada M, Satoh F, Maekawa T, Morimoto R, Yamazaki Y et al. Intratumoral heterogeneity of steroidogenesis in aldosteroneproducing adenoma revealed by intensive double and tripleimmunostaining for CYP11B2/B1 and CYP17. Mol Cell Endocrinol. 2016;422:57–63. https://doi.org/10.1016/j.mce.2015.11.014.Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889–1916. https://doi.org/10.1210/jc.2015-4061.Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889–1916. https://doi.org/10.1210/jc.2015-4061.Monticone S, Burrello J, Tizzan D, Bertello C, Viola A, Buffolo F. Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practic. J Am Coll Cardiol. 2017;69(14):1811–1820. https://doi.org/10.1016/j.jacc.2017.01.052.Monticone S, Burrello J, Tizzan D, Bertello C, Viola A, Buffolo F. Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practic. J Am Coll Cardiol. 2017;69(14):1811–1820. https://doi.org/10.1016/j.jacc.2017.01.052.Salvetti M, Paini A, Bertacchini F, Aggiusti C, Stassaldi D, Capellini S et al. Myocardial mechano-energetic efficiency in primary aldosteronism. J Hypertens. 2021;39(2):318–324. https://doi.org/10.1097/HJH.0000000000002637.Salvetti M, Paini A, Bertacchini F, Aggiusti C, Stassaldi D, Capellini S et al. Myocardial mechano-energetic efficiency in primary aldosteronism. J Hypertens. 2021;39(2):318–324. https://doi.org/10.1097/HJH.0000000000002637.Young MJ, Clyne CD. Mineralocorticoid receptor actions in cardiovascular development and disease. Essays Biochem. 2021;65(6):901–911. https://doi.org/10.1042/EBC20210006.Young MJ, Clyne CD. Mineralocorticoid receptor actions in cardiovascular development and disease. Essays Biochem. 2021;65(6):901–911. https://doi.org/10.1042/EBC20210006.Monticone S, D’Ascenzo F, Moretti C, Williams TA, Veglio F, Gaita F, Mulatero P. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018;6(1):41–50. https://doi.org/10.1016/S2213-8587(17)30319-4.Monticone S, D’Ascenzo F, Moretti C, Williams TA, Veglio F, Gaita F, Mulatero P. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018;6(1):41–50. https://doi.org/10.1016/S2213-8587(17)30319-4.Zhou F, Wu T, Wang W, Cheng W, Wan S, Tian H et al. CMR-Verified Myocardial Fibrosis Is Associated With Subclinical Diastolic Dysfunction in Primary Aldosteronism Patients. Front Endocrinol (Lausanne). 2021;12:672557. https://doi.org/10.3389/fendo.2021.672557.Zhou F, Wu T, Wang W, Cheng W, Wan S, Tian H et al. CMR-Verified Myocardial Fibrosis Is Associated With Subclinical Diastolic Dysfunction in Primary Aldosteronism Patients. Front Endocrinol (Lausanne). 2021;12:672557. https://doi.org/10.3389/fendo.2021.672557.Buonafine M, Bonnard B, Jaisser F. Mineralocorticoid Receptor and Cardiovascular Disease. Am J Hypertens. 2018;31(11):1165–1174. https://doi.org/10.1093/ajh/hpy120.Buonafine M, Bonnard B, Jaisser F. Mineralocorticoid Receptor and Cardiovascular Disease. Am J Hypertens. 2018;31(11):1165–1174. https://doi.org/10.1093/ajh/hpy120.Redheuil A, Blanchard A, Pereira H, Raissouni Z, Lorthioir A, Soulat G et al. Aldosterone-Related Myocardial Extracellular Matrix Expansion in Hypertension in Humans: A Proof-of-Concept Study by Cardiac Magnetic Resonance. JACC Cardiovasc Imaging. 2020;13(10):2149–2159. https://doi.org/10.1016/j.jcmg.2020.06.026.Redheuil A, Blanchard A, Pereira H, Raissouni Z, Lorthioir A, Soulat G et al. Aldosterone-Related Myocardial Extracellular Matrix Expansion in Hypertension in Humans: A Proof-of-Concept Study by Cardiac Magnetic Resonance. JACC Cardiovasc Imaging. 2020;13(10):2149–2159. https://doi.org/10.1016/j.jcmg.2020.06.026.McCurley A, Jaffe IZ. Mineralocorticoid receptors in vascular function and disease. Mol Cell Endocrinol. 2012;350(2):256–265. https://doi.org/10.1016/j.mce.2011.06.014.McCurley A, Jaffe IZ. Mineralocorticoid receptors in vascular function and disease. Mol Cell Endocrinol. 2012;350(2):256–265. https://doi.org/10.1016/j.mce.2011.06.014.Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006;48(11):2293–2300. https://doi.org/10.1016/j.jacc.2006.07.059.Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006;48(11):2293–2300. https://doi.org/10.1016/j.jacc.2006.07.059.Apostolopoulou K, Künzel HE, Gerum S, Merkle K, Schulz S, Fischer E et al. Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: a cross-sectional study. World J Biol Psychiatry. 2014;15(1):26–35. https://doi.org/10.3109/15622975.2012.665480.Apostolopoulou K, Künzel HE, Gerum S, Merkle K, Schulz S, Fischer E et al. Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: a cross-sectional study. World J Biol Psychiatry. 2014;15(1):26–35. https://doi.org/10.3109/15622975.2012.665480.Indra T, Holaj R, Štrauch B, Rosa J, Petrák O, Šomlóová Z, Widimský J Jr. Long-term effects of adrenalectomy or spironolactone on blood pressure control and regression of left ventricle hypertrophy in patients with primary aldosteronism. J Renin Angiotensin Aldosterone Syst. 2015;16(4):1109–1117. https://doi.org/10.1177/1470320314549220.Indra T, Holaj R, Štrauch B, Rosa J, Petrák O, Šomlóová Z, Widimský J Jr. Long-term effects of adrenalectomy or spironolactone on blood pressure control and regression of left ventricle hypertrophy in patients with primary aldosteronism. J Renin Angiotensin Aldosterone Syst. 2015;16(4):1109–1117. https://doi.org/10.1177/1470320314549220.Briet M, Schiffrin EL. Vascular Actions of Aldosterone. J Vasc Res. 2013;50(2):89–99. https://doi.org/10.1159/000345243.Briet M, Schiffrin EL. Vascular Actions of Aldosterone. J Vasc Res. 2013;50(2):89–99. https://doi.org/10.1159/000345243.Jin HM, Zhou DC, Gu HF, Qiao QY, Fu SK, Liu XL, Pan Y. Antioxidant N-acetylcysteine protects pancreatic β-cells against aldosteroneinduced oxidative stress and apoptosis in female db/db mice and insulin-producing MIN6 cells. Endocrinology. 2013;154(11):4068–4077. https://doi.org/10.1210/en.2013-1115.Jin HM, Zhou DC, Gu HF, Qiao QY, Fu SK, Liu XL, Pan Y. Antioxidant N-acetylcysteine protects pancreatic β-cells against aldosteroneinduced oxidative stress and apoptosis in female db/db mice and insulin-producing MIN6 cells. Endocrinology. 2013;154(11):4068–4077. https://doi.org/10.1210/en.2013-1115.Hanslik G, Wallaschofski H, Dietz A, Riester A, Reincke M, Allolio B et al. Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn’s Registry. Eur J Endocrinol. 2015;173(5):665–675. https://doi.org/10.1530/EJE-15-0450.Hanslik G, Wallaschofski H, Dietz A, Riester A, Reincke M, Allolio B et al. Increased prevalence of diabetes mellitus and the metabolic syndrome in patients with primary aldosteronism of the German Conn’s Registry. Eur J Endocrinol. 2015;173(5):665–675. https://doi.org/10.1530/EJE-15-0450.Späth M, Korovkin S, Antke C, Anlauf M, Willenberg HS. Aldosteroneand cortisol-co-secreting adrenal tumors: the lost subtype of primary aldosteronism. Eur J Endocrinol. 2011;164(4):447–455. https://doi.org/10.1530/EJE-10-1070.Späth M, Korovkin S, Antke C, Anlauf M, Willenberg HS. Aldosteroneand cortisol-co-secreting adrenal tumors: the lost subtype of primary aldosteronism. Eur J Endocrinol. 2011;164(4):447–455. https://doi.org/10.1530/EJE-10-1070.Di Dalmazi G, Berr CM, Fassnacht M, Beuschlein F, Reincke M. Adrenal Function After Adrenalectomy for Subclinical Hypercortisolism and Cushing’s Syndrome: A Systematic Review of the Literature. J Clin Endocrinol Metab. 2014;99(8):2637–2645. https://doi.org/10.1210/jc.2014-1401.Di Dalmazi G, Berr CM, Fassnacht M, Beuschlein F, Reincke M. Adrenal Function After Adrenalectomy for Subclinical Hypercortisolism and Cushing’s Syndrome: A Systematic Review of the Literature. J Clin Endocrinol Metab. 2014;99(8):2637–2645. https://doi.org/10.1210/jc.2014-1401.Goupil R, Wolley M, Ahmed AH, Gordon RD, Stowasser M. Does concomitant autonomous adrenal cortisol overproduction have the potential to confound the interpretation of adrenal venous sampling in primary aldosteronism? Clin Endocrinol (Oxf ). 2015;83(4):456–461. https://doi.org/10.1111/cen.12750.Goupil R, Wolley M, Ahmed AH, Gordon RD, Stowasser M. Does concomitant autonomous adrenal cortisol overproduction have the potential to confound the interpretation of adrenal venous sampling in primary aldosteronism? Clin Endocrinol (Oxf ). 2015;83(4):456–461. https://doi.org/10.1111/cen.12750.Мельниченко ГА, Платонова НМ, Бельцевич ДГ, Юкина МЮ, Молашенко НВ, Трошина ЕА. Первичный гиперальдостеронизм: диагностика и лечение. Новый взгляд на проблему. По материалам Проекта клинических рекомендаций Российской ассоциации эндокринологов по диагностике и лечению первичного гиперальдостеронизма. Consilium Medicum. 2017;19(4):75–85. Режим доступа: https://consilium.orscience.ru/2075-1753/article/view/94823.Melnichenko GA, Platonova NM, Beltsevich DG, Yukina MYu, Molashenko NV, Troshina EA. Primary hyperaldosteronism: diagnosis and treatment. A new look at the problem. According to the materials of the Russian Association of Endocrinologists clinical guidelines for primary hyperaldosteronism diagnosis and treatment. Consilium Medicum. 2017;19(4):75–85. (In Russ.) Available at: https://consilium.orscience.ru/2075-1753/article/view/94823.Чихладзе НМ. Первичный гиперальдостеронизм: показания для скрининга. Терапевтический архив. 2022;94(1):107–113. https://doi.org/10.26442/00403660.2022.01.201324.Chikhladze NM. Primary hyperaldosteronism: indications for screening. Terapevticheskii Arkhiv. 2022;94(1):107–113. (In Russ.) https://doi.org/10.26442/00403660.2022.01.201324.Baguet JP, Steichen O, Mounier-Véhier C, Gosse P. SFE/SFHTA/AFCE consensus on primary aldosteronism, part 1: Epidemiology of PA, who should be screened for sporadic PA? Ann Endocrinol (Paris). 2016;77(3):187–191. https://doi.org/10.1016/j.ando.2016.01.006.Baguet JP, Steichen O, Mounier-Véhier C, Gosse P. SFE/SFHTA/AFCE consensus on primary aldosteronism, part 1: Epidemiology of PA, who should be screened for sporadic PA? Ann Endocrinol (Paris). 2016;77(3):187–191. https://doi.org/10.1016/j.ando.2016.01.006.Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC et al. Study heterogeneity and estimation of prevalence of primary aldosteronism: a systematic review and meta-regression analysis. J Clin Endocrinol Metab. 2016;101(7):2826–2835. https://doi.org/10.1210/jc.2016-1472.Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC et al. Study heterogeneity and estimation of prevalence of primary aldosteronism: a systematic review and meta-regression analysis. J Clin Endocrinol Metab. 2016;101(7):2826–2835. https://doi.org/10.1210/jc.2016-1472.Young WF Jr. Diagnosis and treatment of primary aldosteronism: practical clinical perspectives. J Intern Med. 2019;285(2):126–148. https://doi.org/10.1111/joim.12831.Young WF Jr. Diagnosis and treatment of primary aldosteronism: practical clinical perspectives. J Intern Med. 2019;285(2):126–148. https://doi.org/10.1111/joim.12831.Янг У, Ладыгина ДО, Балутина ОВ, Бельцевич ДГ. Первичный гиперальдостеронизм: подход клиники Мэйо. Терапевтический архив. 2020;92(10):83–87. https://doi.org/10.26442/00403660.2020.10.000754.Young W, Ladygina DO, Balutina OV, Beltsevich DG. Primary aldosteronism: The Mayo Clinic approach. Terapevticheskii Arkhiv. 2020;92(10): 83–87. (In Russ.) https://doi.org/10.26442/00403660.2020.10.000754.Титова ВВ, Кисляк ОА, Демидова ТЮ. Эндокринная артериальная гипертензия: причины развития, принципы диагностики и лечения. Лекция для врачей. FOCUS Эндокринология. 2021;(4):31–38. Режим доступа: https://endo-club.ru/upload/iblock/6d6/6d6bd2f-513820c533978a6e7d1853925.pdf.Titova VV, Kislyak OA, Demidova TYu. Endocrine arterial hypertension: causes of development, principles of diagnosis and treatment. Lecture for doctors. FOCUS Endocrinology. 2021;(4):31–38. (In Russ.) Available at: https://endo-club.ru/upload/iblock/6d6/6d6bd2f513820c533978a6e7d1853925.pdf.Fukumoto T, Umakoshi H, Ogata M, Yokomoto-Umakoshi M, Matsuda Y, Motoya M et al. Significance of Discordant Results Between Confirmatory Tests in Diagnosis of Primary Aldosteronism. J Clin Endocrinol Metab. 2021;106(2):e866–e874. https://doi.org/10.1210/clinem/dgaa812.Fukumoto T, Umakoshi H, Ogata M, Yokomoto-Umakoshi M, Matsuda Y, Motoya M et al. Significance of Discordant Results Between Confirmatory Tests in Diagnosis of Primary Aldosteronism. J Clin Endocrinol Metab. 2021;106(2):e866–e874. https://doi.org/10.1210/clinem/dgaa812.Tong A, Liu G, Wang F, Jiang J, Yan Z, Zhang D et al. A Novel Phenotype of Familial Hyperaldosteronism Type III: Concurrence of Aldosteronism and Cushing’s Syndrome. J Clin Endocrinol Metab. 2016;101(11):4290–4297. https://doi.org/10.1210/jc.2016-1504.Tong A, Liu G, Wang F, Jiang J, Yan Z, Zhang D et al. A Novel Phenotype of Familial Hyperaldosteronism Type III: Concurrence of Aldosteronism and Cushing’s Syndrome. J Clin Endocrinol Metab. 2016;101(11):4290–4297. https://doi.org/10.1210/jc.2016-1504.Корб ТА, Чернина ВЮ, Блохин ИА, Алешина ОО, Воронцов АВ, Морозов СП, Гомболевский ВА. Визуализация надпочечников: в норме и при патологии (обзор литературы). Проблемы эндокринологии. 2021;67(3):26–36. https://doi.org/10.14341/probl12752.Korb TA, Chernina VYu, Blokhin IA, Aleshina OO, Vorontsov AV, Morozov SP, Gombolevskiy VA. Adrenal imaging: anatomy and pathology (literature review). Problems of Endocrinology. 2021;67(3):26–36. (In Russ.) https://doi.org/10.14341/probl12752.Kishino M, Yoshimoto T, Nakadate M, Katada Y, Kanda E, Nakaminato S et al. Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion. Endocr J. 2017;64(3):347–355. https://doi.org/10.1507/endocrj.EJ16-0433.Kishino M, Yoshimoto T, Nakadate M, Katada Y, Kanda E, Nakaminato S et al. Optimization of left adrenal vein sampling in primary aldosteronism: Coping with asymmetrical cortisol secretion. Endocr J. 2017;64(3):347–355. https://doi.org/10.1507/endocrj.EJ16-0433.Seo JM, Park BK, Park SY, Kim CK. Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT. AJR Am J Roentgenol. 2014;202(5):1043–1050. https://doi.org/10.2214/AJR.13.11389.Seo JM, Park BK, Park SY, Kim CK. Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT. AJR Am J Roentgenol. 2014;202(5):1043–1050. https://doi.org/10.2214/AJR.13.11389.Johnson PT, Horton KM, Fishman EK. Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics. 2009;29(5):1333–1351. https://doi.org/10.1148/rg.295095027.Johnson PT, Horton KM, Fishman EK. Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics. 2009;29(5):1333–1351. https://doi.org/10.1148/rg.295095027.Young WF Jr. Conventional imaging in adrenocortical carcinoma: update and perspectives. Horm Cancer. 2011;2(6):341–347. https://doi.org/10.1007/s12672-011-0089-z.Young WF Jr. Conventional imaging in adrenocortical carcinoma: update and perspectives. Horm Cancer. 2011;2(6):341–347. https://doi.org/10.1007/s12672-011-0089-z.Mayo-Smith WW, Song JH, Boland GL, Francis IR, Israel GM, Mazzaglia PJ et al. Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2017;14(8):1038–1044. https://doi.org/10.1016/j.jacr.2017.05.001.Mayo-Smith WW, Song JH, Boland GL, Francis IR, Israel GM, Mazzaglia PJ et al. Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2017;14(8):1038–1044. https://doi.org/10.1016/j.jacr.2017.05.001.Patel D, Gara SK, Ellis RJ, Boufraqech M, Nilubol N, Millo C et al. FDG PET/CT Scan and Functional Adrenal Tumors: A Pilot Study for Lateralization. World J Surg. 2016;40(3):683–689. https://doi.org/10.1007/s00268-015-3242-y.Patel D, Gara SK, Ellis RJ, Boufraqech M, Nilubol N, Millo C et al. FDG PET/CT Scan and Functional Adrenal Tumors: A Pilot Study for Lateralization. World J Surg. 2016;40(3):683–689. https://doi.org/10.1007/s00268-015-3242-y.Akkuş G, Güney IB, Ok F, Evran M, Izol V, Erdoğan Ş et al. Diagnostic efficacy of 18F-FDG PET/CT in patients with adrenal incidentaloma. Endocr Connect. 2019;8(7):838–845. https://doi.org/10.1530/EC-19-0204.Akkuş G, Güney IB, Ok F, Evran M, Izol V, Erdoğan Ş et al. Diagnostic efficacy of 18F-FDG PET/CT in patients with adrenal incidentaloma. Endocr Connect. 2019;8(7):838–845. https://doi.org/10.1530/EC-19-0204.Haider MA, Ghai S, Jhaveri K, Lockwood G. Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology. 2004;231(3):711–716. https://doi.org/10.1148/radiol.2313030676.Haider MA, Ghai S, Jhaveri K, Lockwood G. Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology. 2004;231(3):711–716. https://doi.org/10.1148/radiol.2313030676.Albano D, Agnello F, Midiri F, Pecoraro G, Bruno A, Alongi P et al. Imaging features of adrenal masses. Insights Imaging. 2019;10(1):1. https://doi.org/10.1186/s13244-019-0688-8.Albano D, Agnello F, Midiri F, Pecoraro G, Bruno A, Alongi P et al. Imaging features of adrenal masses. Insights Imaging. 2019;10(1):1. https://doi.org/10.1186/s13244-019-0688-8.Sande EP, Martinsen AC, Hole EO, Olerud HM. Interphantom and interscanner variations for Hounsfield units – establishment of reference values for HU in a commercial QA phantom. Phys Med Biol. 2010;55(17):5123–5135. https://doi.org/10.1088/0031-9155/55/17/015.Sande EP, Martinsen AC, Hole EO, Olerud HM. Interphantom and interscanner variations for Hounsfield units – establishment of reference values for HU in a commercial QA phantom. Phys Med Biol. 2010;55(17):5123–5135. https://doi.org/10.1088/0031-9155/55/17/015.Stadler A, Schima W, Prager G, Homolka P, Heinz G, Saini S et al. CT density measurements for characterization of adrenal tumors ex vivo: variability among three CT scanners. AJR Am J Roentgenol. 2004;182(3):671–675. https://doi.org/10.2214/ajr.182.3.1820671.Stadler A, Schima W, Prager G, Homolka P, Heinz G, Saini S et al. CT density measurements for characterization of adrenal tumors ex vivo: variability among three CT scanners. AJR Am J Roentgenol. 2004;182(3):671–675. https://doi.org/10.2214/ajr.182.3.1820671.Williams TA, Burrello J, Sechi LA, Fardella CE, Matrozova J, Adolf C et al. Computed tomography and adrenal venous sampling in the diagnosis of unilateral primary aldosteronism. Hypertension. 2018;72(3):641–649. https://doi.org/10.1161/HYPERTENSIONAHA.118.11382.Williams TA, Burrello J, Sechi LA, Fardella CE, Matrozova J, Adolf C et al. Computed tomography and adrenal venous sampling in the diagnosis of unilateral primary aldosteronism. Hypertension. 2018;72(3):641–649. https://doi.org/10.1161/HYPERTENSIONAHA.118.11382.Gkaniatsa E, Sakinis A, Palmér M, Muth A, Trimpou P, Ragnarsson O. Adrenal Venous Sampling in Young Patients with Primary Aldosteronism. Extravagance or Irreplaceable? J Clin Endocrinol Metab. 2021;106(5):e2087–e2095. https://doi.org/10.1210/clinem/dgab047.Gkaniatsa E, Sakinis A, Palmér M, Muth A, Trimpou P, Ragnarsson O. Adrenal Venous Sampling in Young Patients with Primary Aldosteronism. Extravagance or Irreplaceable? J Clin Endocrinol Metab. 2021;106(5):e2087–e2095. https://doi.org/10.1210/clinem/dgab047.Lim V, Guo Q, Grant CS, Thompson GB, Richards ML, Farley DR, Young WF Jr. Accuracy of adrenal imaging and adrenal venous sampling in predicting surgical cure of primary aldosteronism. J Clin Endocrinol Metab. 2014;99(8):2712–2719. https://doi.org/10.1210/jc.2013-4146.Lim V, Guo Q, Grant CS, Thompson GB, Richards ML, Farley DR, Young WF Jr. Accuracy of adrenal imaging and adrenal venous sampling in predicting surgical cure of primary aldosteronism. J Clin Endocrinol Metab. 2014;99(8):2712–2719. https://doi.org/10.1210/jc.2013-4146.Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63(1):151–160. https://doi.org/10.1161/HYPERTENSIONAHA.113.02097.Rossi GP, Auchus RJ, Brown M, Lenders JW, Naruse M, Plouin PF et al. An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension. 2014;63(1):151–160. https://doi.org/10.1161/HYPERTENSIONAHA.113.02097.Webb R, Mathur A, Chang R, Baid S, Nilubol N, Libutti SK et al. What is the best criterion for the interpretation of adrenal vein sample results in patients with primary hyperaldosteronism? Ann Surg Oncol. 2012;19(6):1881–1886. https://doi.org/10.1245/s10434-011-2121-5.Webb R, Mathur A, Chang R, Baid S, Nilubol N, Libutti SK et al. What is the best criterion for the interpretation of adrenal vein sample results in patients with primary hyperaldosteronism? Ann Surg Oncol. 2012;19(6):1881–1886. https://doi.org/10.1245/s10434-011-2121-5.Arjani S, Bostonian TJ, Prasath V, Quinn PL, Chokshi RJ. Costeffectiveness of adrenal vein samplingvs computed tomographyguided adrenalectomy for unilateral adrenaloma in primary aldosteronism. J Endocrinol Invest. 2022;45(10):1899–1908. https://doi.org/10.1007/s40618-022-01821-7.Arjani S, Bostonian TJ, Prasath V, Quinn PL, Chokshi RJ. Costeffectiveness of adrenal vein samplingvs computed tomographyguided adrenalectomy for unilateral adrenaloma in primary aldosteronism. J Endocrinol Invest. 2022;45(10):1899–1908. https://doi.org/10.1007/s40618-022-01821-7.Goupil R, Wolley M, Ungerer J, McWhinney B, Mukai K, Naruse M et al. Use of plasma metanephrine to aid adrenal venous sampling in combined aldosterone and cortisol over-secretion. Endocrinol Diabetes Metab Case Rep. 2015:150075. https://doi.org/10.1530/EDM-15-0075.Goupil R, Wolley M, Ungerer J, McWhinney B, Mukai K, Naruse M et al. Use of plasma metanephrine to aid adrenal venous sampling in combined aldosterone and cortisol over-secretion. Endocrinol Diabetes Metab Case Rep. 2015:150075. https://doi.org/10.1530/EDM-15-0075.

The authors declare that there are no conflicts of interest present.