PRIMARY HYPERALDOSTERONISM IN SECONDARY CARE: EXPERIENCE REPORT BASED ON A CASE SERIES

Abstract

Introduction: Primary hyperaldosteronism (PAH) is a common but often underdiagnosed cause of secondary arterial hypertension in adults. It is characterized by excessive production of aldosterone, with its main causes being bilateral adrenal hyperplasia and aldosterone-producing adenoma. The diagnosis is made by measuring the aldosterone-renin ratio (ARR), and differentiation between etiologies is essential in order to direct treatment, which may be clinical or surgical. Early diagnosis is essential to enable a curative approach and prevent complications. Therefore, this study aims to report two cases of PAH, highlighting the clinical, laboratory and imaging findings, as well as the diagnostic and therapeutic management, emphasizing the importance of clinical suspicion and appropriate management at secondary levels of health care. Objective: To report the clinical experience with two cases of PAH followed in a secondary care service, highlighting the diagnostic and therapeutic challenges. Methodology Results: Case 01 - 42-year-old patient with resistant hypertension and hypokalemia, diagnosed with PAH through RAR. Treated with spironolactone, she evolved well and is asymptomatic. Case 02 - 60-year-old patient with hypertension and headache, diagnosed with PAH through RAR, with probable bilateral adrenal hyperplasia, treated with losartan, maintaining good blood pressure control. Conclusion: Early detection of PAH allows effective treatment, improving blood pressure control and preventing long-term complications.