Primary aldosteronism: A Japanese perspective

Primary aldosteronism (PA) is the most common cause of secondary hypertension, accounting for 10% of all hypertension. Far from being benign, hypertension due to PA is associated with high cardiovascular morbidity and mortality. However, PA is still underdiagnosed in general practice. Recent reports strongly recommend that identifying patients with PA is cost-beneficial based on improved cardiovascular outcomes afforded by specific surgical and medical treatment. This review provides an update of PA including controversial aspects of diagnosis and treatment

22-Year-old patient with malignant hypertension associated with primary aldosteronism

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Impact of Endocrine Disorders on Vasculature

Endothelial cells (ECs) and vascular smooth muscle cells (VSMCs) regulate essential vascular functions, including contractility, inflammation, and platelet activity. Endothelial dysfunction represents an early marker of impaired vascular homeostasis as well as a strong predictor of atherosclerosis and future cardiovascular (CV) events. Many hormones interact with ECs and VSMCs, thus playing a key role in vascular homeostasis. On this basis, endocrine disorders may be considered as a paradigm of endocrine control on vascular health. On the one hand, they contribute to understanding the pathophysiological mechanisms underlying vascular dysfunction. Furthermore, the tight control of endocrine pathways on vascular function emphasizes their pleiotropic activity and the interplay between different hormonal axes. Here, we summarize the current knowledge linking endocrine system and vascular health. Direct effects of insulin, thyroid hormones, mineralo- and glucocorticoids, growth hormone/insulinlike growth factor, sexual hormones, and calcium/phosphorus regulating hormones will be analyzed, also considering the complex interplay between those different pathways. Both molecular mechanisms and clinical evidence will be discussed also describing the potential role of different hormones as potential biomarkers of atherosclerosis and risk of adverse cardiovascular events