Hypertension is the third leading cause ofdisability adjusted life years, and its prevalence has increased over the pastdecade. In Primary Aldosteronism, adrenal glands overproduce aldosterone, thatresults in loss of potassium along with sodium retention, leading to secondaryhypertension.
However, patients diagnosed with PA, subsequently developed metabolic disorders, such as InsulinResistance, Type 2 DM, Osteoporosis and depression, which are indicative of cortisol overproduction (CushingSyndrome). Connshing Syndrome is a combination of both Primary Aldosteronism& Cushing’s Syndrome.METHODOLOGY:Extensivebackground literature survey was conducted for a period of 6 months, to find asignificant role of Connshing Syndrome in secondary hypertension and associatedperivascular complications.DISCUSSION:In Primary Aldosteronism, metabolic disorders are associated withcortisol co-secretion. Patients with Conn Syndrome had significantly increasedcortisol & glucocorticoid metabolite excretion. InPA, the adrenal glandsnot only overproduce aldosterone, but also cortisol. Aldosterone excess hasbeen found to be associated with disorders in glucose metabolism, and may alsocontribute to cardiovascular damage. Adrenalectomy in patients with PrimaryAldosteronism significantly reduces the risks of New-Onset Diabetes Mellitus,compared to that of mineralocorticoid receptor antagonist therapy.
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Adrenalaldosterone excess is the most common cause of secondary hypertension, and isassociated with increased cardiovascular morbidity. Adversemetabolic risk in PA, extends beyond hypertension, with high rates of insulinresistance, Type 2 DM, & osteoporosis, that have no links with aldosteroneexcess. In patients withadrenal incidentalomas, studies suggest the presence of a link between subclinicalhypercortisolism, and an increased prevalence of vertebral fractures & spinaldeformity. It was found that subclinical hypercortisolismis associated with an increased risk of vertebral fractures, with a possibledeterioration of bone quality. Aldosterone excess has been found to beassociated with glucose disorders, and may contribute to cardiovascular damage.Blood glucose & SBP were higher, & duration of HTN was longer in PA,than in EH. Prevalence of metabolic syndrome was higher in PA, than in EH.
Thefindings confirm a negative effect of aldosterone excess on glucose metabolism.