ARTICLE TYPE : RESEARCH ARTICLE
Published on : 13 May 2026,
Volume - 2
Journal Title :
WebLog Journal of Nephrology and Hypertension
| WebLog J Nephrol Hypertens
| WJNH
Source URL:
https://weblogoa.com/articles/wjnh.2026.e1304
Permanent Identifier (DOI) :
https://doi.org/10.5281/zenodo.20210925
Abdominal Aortic Dissection Associated with Primary Aldosteronism: A Case Report and Review of Emerging Evidence
#Both authors contributed equally
Abstract
Primary aldosteronism (PA) is a common and potentially curable cause of secondary hypertension associated with increased cardiovascular morbidity and mortality beyond blood pressure levels. Aldosterone excess contributes to vascular damage through pro-inflammatory, pro-fibrotic and remodelling effects on the arterial wall. An association between PA and aortic diseases has been increasingly reported but remains underrecognized in clinical practice.
We report a case of a 52-year-old woman referred to the emergency room due to acute abdominal and lower limb pain with detection of subrenal aortic dissection on contrast-enhanced computed tomography (CECT). Given her young age and newly diagnosed hypertension, a secondary cause was investigated. An elevated aldosterone-to-renin ratio was detected and autonomous aldosterone secretion was confirmed by saline infusion test. Review of imaging revealed a left adrenal nodule. Adrenal vein sampling (AVS) showed significant left-sided lateralization. The patient was deemed eligible for left adrenalectomy. Following surgery, she progressively reduced antihypertensive therapy. Genetic analysis showed a germline mutation in CLCN2, indicative of familial hyperaldosteronism type II.
This case supports the emerging link between PA and aortic dissection suggesting that aldosterone excess may play a direct pathogenic role in aortic wall vulnerability, independently of hypertension severity. Screening for PA should be considered in patients with aortic dissection and hypertension as early diagnosis and targeted treatment may reduce the risk of severe cardiovascular (CV) complications.
Keywords: Primary Aldosteronism; Aortic Dissection; Mineralocorticoid Receptor; Endocrine Hypertension; Vascular Remodeling; Familial Hyperaldosteronism
Citation
Percudani G, Canè MG, Cunzi D, Severi D, Prampolini G, Zoino JL, et al. Abdominal Aortic Dissection Associated with Primary Aldosteronism: A Case Report and Review of Emerging Evidence. wjnh.2026.e1304. https://doi.org/10.5281/zenodo.20210925