Hypertension be associated with glucose disorders, and may contribute

Hypertension is the third leading cause of
disability adjusted life years, and its prevalence has increased over the past
decade. In Primary Aldosteronism, adrenal glands overproduce aldosterone, that
results in loss of potassium along with sodium retention, leading to secondary
hypertension. However, patients diagnosed with 
PA, subsequently developed metabolic disorders, such as Insulin
Resistance, Type 2 DM, Osteoporosis and depression, which are  indicative of cortisol overproduction (Cushing
Syndrome). Connshing Syndrome is a combination of both Primary Aldosteronism
& Cushing’s Syndrome.


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background literature survey was conducted for a period of 6 months, to find a
significant role of Connshing Syndrome in secondary hypertension and associated
perivascular complications.


In Primary Aldosteronism, metabolic disorders are associated with
cortisol co-secretion. Patients with Conn Syndrome had significantly increased
cortisol & glucocorticoid metabolite excretion. InPA, the adrenal glands
not only overproduce aldosterone, but also cortisol. Aldosterone excess has
been found to be associated with disorders in glucose metabolism, and may also
contribute to cardiovascular damage. Adrenalectomy in patients with Primary
Aldosteronism significantly reduces the risks of New-Onset Diabetes Mellitus,
compared to that of mineralocorticoid receptor antagonist therapy. Adrenal
aldosterone excess is the most common cause of secondary hypertension, and is
associated with increased cardiovascular morbidity. Adverse
metabolic risk in PA, extends beyond hypertension, with high rates of insulin
resistance, Type 2 DM, & osteoporosis, that have no links with aldosterone
excess. In patients with
adrenal incidentalomas, studies suggest the presence of a link between subclinical
hypercortisolism, and an increased prevalence of vertebral fractures & spinal
deformity. It was found that subclinical hypercortisolism
is associated with an increased risk of vertebral fractures, with a possible
deterioration of bone quality. Aldosterone excess has been found to be
associated 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. The
findings confirm a negative effect of aldosterone excess on glucose metabolism.