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Cardiovascular disease

Non-invasive detection of a common, surgically correctable form of hypertension

Nature Medicine volume 29, pages 31–32 (2023)Cite this article

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A clinical trial shows the feasibility of a noninvasive imaging approach to diagnose a surgically amenable subtype of primary aldosteronism — a common and often poorly managed form of hypertension.

Primary aldosteronism is the most common surgically correctable form of hypertension. It is caused by excessive production of the adrenal steroid hormone aldosterone, which is often a result of an adrenocortical (aldosterone-producing) adenoma1. Primary aldosteronism is severely underdiagnosed in healthcare systems, a situation amplified by reports suggesting that it might be even more prevalent than previously thought2. The disease is diagnosed through a three-step procedure involving a positive screening test followed by confirmatory testing and finally subtype differentiation to distinguish unilateral aldosterone hypersecretion—for which surgical removal of the affected adrenal gland is recommended—from bilateral disease, which is conventionally treatable by mineralocorticoid receptor antagonist therapy1,3. But the identification of patients for potentially curative adrenalectomy can be challenging. In this issue of Nature Medicine, Wu et al.4 test the utility of a noninvasive functional adrenal imaging procedure for surgical management in primary aldosteronism.

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Fig. 1: Functional imaging for the detection of aldosterone-producing adenomas.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, LMU München, Munich, Germany

    Tracy Ann Williams & Martin Reincke

  2. Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy

    Tracy Ann Williams

Authors
  1. Tracy Ann Williams
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  2. Martin Reincke
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Correspondence to Tracy Ann Williams.

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Williams, T.A., Reincke, M. Non-invasive detection of a common, surgically correctable form of hypertension. Nat Med 29, 31–32 (2023). https://doi.org/10.1038/s41591-022-02083-9

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