Cardiac Structure and Function in Hyperaldosteronism.

Chronic activation of the renin–angiotensin–aldosterone system is known to be associated with cardiovascular injury. Primary aldosteronism (PA), either from bilateral adrenal hyperplasia or an aldosterone-secreting tumor, is one of the principal causes of secondary hypertension. The combined vascular resistance and sodium retention lead to increased afterload and result in increased left ventricular (LV) wall thickness, most often with minimal change in LV diameter. However, left ventricular hypertrophy (LVH) is more common and more pronounced in PA than in either essential hypertension or in other secondary forms of hypertension, such as pheochromocytoma or Cushing disease. Tissue Doppler studies have also demonstrated a higher prevalence of subclinical abnormalities of systolic and diastolic dysfunction in patients with this condition compared with age-matched patients with essential hypertension.