Work-packages 1: Aldosterone

WP1. Diagnosis and sub-differentiation of patients with primary aldosteronism
Prof. Dr. Felix Beuschlein and Prof. Dr. Adriano Aguzzi

Around 25% of the hypertensive patients resistant to therapy have a diagnosis of primary aldosteronism (PA). Early diagnosis of PA subtypes followed by correct treatment has a major impact on clinical outcome since it can reverse the increased risk of cardiovascular and cerebrovascular complications associated with the disease. Adrenal venous sampling is the procedure recommended to distinguish the main PA subtypes. There are, however, several limitations to this procedure, which is technically demanding and laborious. Recent findings suggest the potential to improve diagnostic procedures with the help of multi-steroid analysis as aimed at in the current work-package. At the same time, this progress highlights the scarce knowledge on the pathophysiology of PA subtypes. In addition to very rare monogenetic disorders giving rise to early onset PA due to bilateral hyperplasia, there is increasing evidence in the literature that antibodies with affinity to components of the RAAS can impact aldosterone output. Specifically, stimulating antibodies against the angiotensin II type I receptor have been identified in the serum of PA patients. The wider distribution of these antibodies and their association with cardiovascular endpoints has not yet been studied and will be addressed in this work- package.