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Professor Michael Stowasser
Professor

Michael Stowasser

Email: 
Phone: 
+61 7 3176 2694

Overview

Background

MS has >30 years of clinical research experience in pathogenesis and management of hypertension (HT) and especially of endocrine varieties including primary aldosteronism (PA). Working within the Greenslopes Hospital Hypertension Unit (GHHU), he played a significant role in the demonstration that PA is much more common than previously thought, and in the description of a new familial form (FH-II). MS has made key contributions to understanding of steroid and BP regulation in another familial form (FH-I). The combined GHHU/Princess Alexandra Hospital HT Unit (PAHHU, which MS set up in 2000) has the largest series (>2000) worldwide of patients with PA who have been thoroughly documented and meticulously studied, helping MS to become internationally recognized as an authority on pathogenesis (including genetics), diagnostic workup and management of PA, including its familial forms. In 2006, he was invited to be a member of an international Task Force sponsored by the US Endocrine Society to develop clinical guidelines for the diagnosis and management of PA.

As at October 2018, MS had published or in press 205 full papers in peer-reviewed journals, 15 chapters for textbooks of medicine (including DeGroot's Endocrinology) and four on-line chapters (including one for Harrison's Online). According to ISI Web of Knowledge, MS’s journal publications have been cited >7000 times. Fifteen have been cited >100 times, one of these >900 (“h” index 44). He has been invited to speak at major meetings 120 times (84 international, 36 national) since 1998 including a debate with Norman Kaplan on the prevalence of PA (ISH, Prague 2002). He was invited by the University of WA to give the Robert Vandongen Memorial Lecture for 2002 and by the Cardiac Society of Australia and New Zealand to deliver the Gaston-Bauer Lecture in 2012. MS has collaborated with researchers in 14 international Units and all Australian states. In 2002, he was named as a Chief Investigator within a newly established Clinical Centre of Research Excellence (CCRE) in Cardiovascular Disease and Metabolic Disorders at Princess Alexandra Hospital, funding for which was renewed by the NHMRC in 2006 for 2007-11. In 2018 he became one of six international investigators to head a Transatlantic Network of Excellence investigating Potassium and Hypertension funded by the Leducq Foundation. Has served on Editorial Boards for J Hypertens, Clin Exper Physiol Pharmacol, Nephrology (Subject Editor), J Clin Endocrinol Metab and J Hum Hypertens (Co-Editor) and assessed manuscripts for >20 major international journals. Has served as written grant application assessor for six major international and five major national funding bodies, on NHF Grant Interviewing Committees in 1997, 1998, 1999, 2001 and 2002, and on NHMRC GRPs in 2003, 2005, 2006, 2007, 2008, 2010 and 2011. MS is a member of the International Society of Hypertension (ISH), American Society of Hypertension and US Endocrine Society. He was elected into the Executive Committee of the High BP Research Council of Australia in 1998, as Secretary in 2001 and as President in 2017. He also served as President of the Asia-Pacific Society of Hypertension in 2019. He was a Member of the NHF BP and Vascular Disease Advisory Committee from 1998 until 2012.

Other Awards and Honours:

NHMRC Postgraduate Medical Research Scholarship, 1992-94 John W.H. Tyrer Prize for Research in Internal Medicine, 1992 NHF Clinical Research Fellowship, 1995-97 NHF Postdoctoral Fellowship, 1998-99 Honorary Professor to the Xinjiang Institute of Hypertension, 2005 Member, Primary Aldosteronism Guidelines Task Force, US Endocrine Society, 2006 Visiting Professor, Tung Wah Eastern Hospital, Hong Kong, 2008 Honorary Professor of the Hypertension Department at Henan Provincial People’s Hospital, the Hypertension Control and Research Center of Henan Province, and the Hypertension Diagnosis and Treatment Center of Henan Province, 2009 Gaston Bauer Lecturer, Cardiac Society of Australia and New Zealand, 2012

Availability

Professor Michael Stowasser is:
Available for supervision
Media expert

Qualifications

  • Bachelor (Honours) of Medicine Surgery, The University of Queensland
  • Doctor of Philosophy, The University of Queensland
  • Royal Australasian College of Physicians, Royal Australasian College of Physicians

Research interests

  • Determining the genetic basis for FH-II and other forms of primary aldosteronism

  • Improving methods of detection, diagnostic workup and management of primary aldosteronism

  • Validating a highly accurate method of measuring aldosterone using tandem mass spectrometry developed within the EHRC

  • Determining genetic factors which may modify phenotypic expression in FH-I, and thereby explain the wide spectrum of hypertens

  • Determining the extent to which aldosterone excess in humans is capable of causing cardiovascular and other organ dysfunction in

Research impacts

Hypertension (high blood pressure) affects around 30% of Australian adults, and is a leading risk factor for stroke. Treatment usually means lifelong medications, potentially costly and poorly tolerated. However, when the cause can be identified, and reversed or specifically treated, the outcomes are often dramatic with patients being able to come off many or all antihypertensives and enjoying markedly improved quality of life, while at the same time reducing their stroke risk.

The Endocrine Hypertension Research Centre (EHRC), a University of Queensland School of Medicine Centre based at Greenslopes and Princess Alexandra Hospitals, conducts internationally acclaimed research into the causes and management of various forms of hypertension, with a major focus on curable and specifically treatable varieties. It is the only Centre of its kind in Queensland and one of only a few internationally recognized Australian groups dedicated to hypertension-related clinical management and research. An important area of our work, for which the Centre has attracted much attention, has been our detailed studies into epidemiological, biochemical, morphological, pathophysiological and genetic aspects of a potentially curable form of hypertension known as primary aldosteronism (PA), in which the adrenal glands produce excessive amounts of salt retaining hormone (aldosterone). The EHRC demonstrated 20 years ago that PA is approximately ten times more common than previously thought, and accounts for as many as 10% of patients with hypertension. This finding has led to the identification of thousands of patients around the world who would otherwise have gone undetected, and in whom hypertension has been cured or markedly improved following surgical or specific medical treatment. More than 2000 thoroughly studied and documented patients with PA (probably the largest series worldwide) in our Centre provide a unique resource for further research into causes, diagnosis and treatment, and have led to important collaborations with first-class overseas investigators.

Research at the EHRC and elsewhere has shown that aldosterone excess in unrecognised PA is associated with significant cardiovascular morbidity which exceeds that due to hypertension alone. For example, the risk of stroke in PA is over four times higher than that for other forms of hypertension. In one rare familial form of PA, detectable by a genetic test developed in our Centre, hypertension can be particular severe and of early onset, leading to death at ages as young as 30 from hypertensive, haemorrhagic stroke. Because this increase risk is completely reversed by specifically treating the PA condition, it is vitally important that as many patients as possible with PA be identified among the hypertensive population. Major challenges exist in accurate diagnosis of PA, prompting our Centre to research better ways to achieve this, including through genetic testing and enhanced clinical and biochemical approaches, so that more people will be detected and given the opportunity to receive superior, highly effective treatment.

Among its many other projects, the Centre is actively involved in unlocking the genetic and molecular code of another form of hypertension known as Gordon syndrome (named after the Centre’s founder, Richard Gordon) which results in excessive retention of salt and potassium by the kidney. This work has the potentially to greatly enhance our understanding of how the kidney regulates salt balance and blood pressure, and to lead to the development of new drugs to treat hypertension and thereby prevent stroke.

Works

Search Professor Michael Stowasser’s works on UQ eSpace

406 works between 1990 and 2024

341 - 360 of 406 works

2000

Journal Article

Identifying Drug-Related Readmissions: Is There a Better Way of Assessing the Contribution of Adverse Medication Events?

Stowasser, Danielle A., Staatz, Christine E., Stowasser, Michael, Coombes, Judith A. and Collins, David M. (2000). Identifying Drug-Related Readmissions: Is There a Better Way of Assessing the Contribution of Adverse Medication Events?. Australian Journal of Hospital Pharmacy, 30 (2), 47-53. doi: 10.1002/jppr200030247

Identifying Drug-Related Readmissions: Is There a Better Way of Assessing the Contribution of Adverse Medication Events?

2000

Conference Publication

Clinical, biochemical and radiological overlap between familial hyperaldosteronism types I and II: Importance of genetic testing

Stowasser, M, Taylor, W, Daunt, N, Slater, G, Rossetti, T and Gordon, R (2000). Clinical, biochemical and radiological overlap between familial hyperaldosteronism types I and II: Importance of genetic testing. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS.

Clinical, biochemical and radiological overlap between familial hyperaldosteronism types I and II: Importance of genetic testing

2000

Journal Article

Treatment of familial hyperaldosteronism type I: only partial suppression of adrenocorticotropin required to correct hypertension

Stowasser, M, Bachmann, AW and Gordon, RD (2000). Treatment of familial hyperaldosteronism type I: only partial suppression of adrenocorticotropin required to correct hypertension. The Journal of Clinical Endocrinology and Metabolism, 85 (9), 3313-3318. doi: 10.1210/jc.85.9.3313

Treatment of familial hyperaldosteronism type I: only partial suppression of adrenocorticotropin required to correct hypertension

2000

Journal Article

Treatment of familial hyperaldosteronism type I: Only partial suppression of adrenocorticotropin required to correct hypertension

Stowasser, M., Bachmann, A. W., Huggard, P. R., Rossetti, T. R. and Gordon, R. D. (2000). Treatment of familial hyperaldosteronism type I: Only partial suppression of adrenocorticotropin required to correct hypertension. Journal of Clinical Endocrinology and Metabolism, 85 (9), 3313-3318. doi: 10.1210/jcem.85.9.6834

Treatment of familial hyperaldosteronism type I: Only partial suppression of adrenocorticotropin required to correct hypertension

2000

Journal Article

How common is adrenal-based mineralocortoid hypertension?

Stowasser, M. (2000). How common is adrenal-based mineralocortoid hypertension?. Current Opinion in Endocrinology & Diabetes, 7 (3), 143-150. doi: 10.1097/00060793-200006000-00007

How common is adrenal-based mineralocortoid hypertension?

2000

Conference Publication

Clinical, biomedical and radiological overlap between familial hyperaldosteronism type I and II: importance of genetic testing

Stowasser, M., Taylor, W., Daunt, N., Slater, G., Rossetti, T. and Gordon, R. D. (2000). Clinical, biomedical and radiological overlap between familial hyperaldosteronism type I and II: importance of genetic testing. Abstracts of the 18th Scientific Meeting of the Int. Society of Hypertension, Chicago, USA, 20-24 Aug 2000. Philadelphia, USA: Lippincott Williams & Wilkins.

Clinical, biomedical and radiological overlap between familial hyperaldosteronism type I and II: importance of genetic testing

2000

Conference Publication

Angiotensin II (AngII) receptors in AngII-responsive (AngII-R) and angII-unresponsive (AngII-U) aldosterone-producing adenoma (APA)

Stowasser, M, Zhuo, J, Ohishi, M, Mendelsohn, F and Gordon, R (2000). Angiotensin II (AngII) receptors in AngII-responsive (AngII-R) and angII-unresponsive (AngII-U) aldosterone-producing adenoma (APA). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS.

Angiotensin II (AngII) receptors in AngII-responsive (AngII-R) and angII-unresponsive (AngII-U) aldosterone-producing adenoma (APA)

2000

Journal Article

Sporadic and familial pheochromocytomas are associated with loss of at least two discrete intervals on chromosome 1p

Benn, DE, Dwight, T, Richardson, AL, Delbridge, L, Bambach, CP, Stowasser, M, Gordon, RD, Marsh, DJ and Robinson, BG (2000). Sporadic and familial pheochromocytomas are associated with loss of at least two discrete intervals on chromosome 1p. Cancer Research, 60 (24), 7048-7051.

Sporadic and familial pheochromocytomas are associated with loss of at least two discrete intervals on chromosome 1p

2000

Journal Article

Severity of hypertension in familial hyperaldosteronism type I: Relationship to gender and degree of biochemical disturbance

Stowasser, M., Bachmann, A. W., Huggard, P. R., Rossetti, T. R. and Gordon, R. D. (2000). Severity of hypertension in familial hyperaldosteronism type I: Relationship to gender and degree of biochemical disturbance. The Journal of Clinical Endocrinology and Metabolism, 85 (6), 2160-2166. doi: 10.1210/jc.85.6.2160

Severity of hypertension in familial hyperaldosteronism type I: Relationship to gender and degree of biochemical disturbance

1999

Journal Article

Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers

Bofinger, A. M., Hawley, C. M., Fisher, P. M., Daunt, N., Stowasser, M. and Gordon, Richard D. (1999). Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers. Journal of Human Hypertension, 13 (8), 517-520.

Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers

1999

Journal Article

Expression of 11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD-2) in the developing human adrenal gland and human adrenal cortical carcinoma and adenoma

Coulter, Catherine L., Smith, Robin E., Stowasser, Michael, Sasano, Hironobu, Krozowski, Zygmunt S. and Gordon, Richard D. (1999). Expression of 11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD-2) in the developing human adrenal gland and human adrenal cortical carcinoma and adenoma. Mollecular and Cellular endocrinology, 154 (1-2), 71-77. doi: 10.1016/S0303-7207(99)00077-5

Expression of 11 beta-hydroxysteroid dehydrogenase type 2 (11 beta-HSD-2) in the developing human adrenal gland and human adrenal cortical carcinoma and adenoma

1999

Conference Publication

Severity of hypertension in familial hyperaldosteronism type I: relationship to gender and degree of biochemical disturbance

Bachmann, A. W., Gordon, R. D., Huggard, P. R., Rossetti, T. and Stowasser, M. (1999). Severity of hypertension in familial hyperaldosteronism type I: relationship to gender and degree of biochemical disturbance. The Endocrine Society's 81st Annual Meeting, San Diego, California, 12-15 June, 1999. Bethesda, USA: The Endocrine Society.

Severity of hypertension in familial hyperaldosteronism type I: relationship to gender and degree of biochemical disturbance

1999

Journal Article

Biochemical evidence of aldosterone overproduction and abnormal regulation in normotensive individuals with familial hyperaldosteronism type I

Stowasser, M, Huggard, PR, Rossetti, TR, Bachmann, AW and Gordon, RD (1999). Biochemical evidence of aldosterone overproduction and abnormal regulation in normotensive individuals with familial hyperaldosteronism type I. Journal of Clinical Endocrinology and Metabolism, 84 (11), 4031-4036. doi: 10.1210/jc.84.11.4031

Biochemical evidence of aldosterone overproduction and abnormal regulation in normotensive individuals with familial hyperaldosteronism type I

1999

Journal Article

Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers

Bofinger, AM, Hawley, CM, Fisher, PM, Daunt, N, Stowasser, M and Gordon, RD (1999). Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers. Journal of Human Hypertension, 13 (8), 517-520. doi: 10.1038/sj.jhh.1000873

Increased severity of multifocal renal arterial fibromuscular dysplasia in smokers

1998

Conference Publication

Expression of 11βHSD-2 in human adrenal cortical carcinoma and adenoma

Coulter, Catherine L., Smith, Robin E., Stowasser, Michael, Sasano, Hironobu, Krozowski, Zygmunt S. and Gordon, Richard D. (1998). Expression of 11βHSD-2 in human adrenal cortical carcinoma and adenoma.

Expression of 11βHSD-2 in human adrenal cortical carcinoma and adenoma

1998

Journal Article

Familial hyperaldosteronism type II: Description of a large kindred and exclusion of the aldosterone synthase (CYP11B2) gene

Torpy, DJ, Gordon, RD, Lin, JP, Huggard, PR, Taymans, SE, Stowasser, M, Chrousos, GP and Stratakis, CA (1998). Familial hyperaldosteronism type II: Description of a large kindred and exclusion of the aldosterone synthase (CYP11B2) gene. Journal of Clinical Endocrinology And Metabolism, 83 (9), 3214-3218. doi: 10.1210/jc.83.9.3214

Familial hyperaldosteronism type II: Description of a large kindred and exclusion of the aldosterone synthase (CYP11B2) gene

1998

Journal Article

Linkage analysis for familial hyperaldosteronism type II: Exclusion of linkage to the aldosterone synthase and angiotensin II receptor genes

Torpy, DJ, Gordon, RD, Stowasser, M, Huggard, PR, Chroussos, GP and Stratakis, CA (1998). Linkage analysis for familial hyperaldosteronism type II: Exclusion of linkage to the aldosterone synthase and angiotensin II receptor genes. Journal of Hypertension, 16, S112-S112.

Linkage analysis for familial hyperaldosteronism type II: Exclusion of linkage to the aldosterone synthase and angiotensin II receptor genes

1998

Journal Article

Success of surgery for primary aldosteronism judged by residual autonomous aldosterone production

Rutherford, JC, Taylor, WL, Stowasser, M and Gordon, RD (1998). Success of surgery for primary aldosteronism judged by residual autonomous aldosterone production. World Journal of Surgery, 22 (12), 1243-1245. doi: 10.1007/s002689900552

Success of surgery for primary aldosteronism judged by residual autonomous aldosterone production

1998

Journal Article

Diagnosis of aldosterone-producing adenoma: Aldosterone/renin ratio and adrenal venous sampling

Stowasser, M, Taylor, WL, Rutherford, JC and Gordon, RD (1998). Diagnosis of aldosterone-producing adenoma: Aldosterone/renin ratio and adrenal venous sampling. Journal of Hypertension, 16, S147-S147.

Diagnosis of aldosterone-producing adenoma: Aldosterone/renin ratio and adrenal venous sampling

1998

Journal Article

Expression of 11 beta HSD-2 in human adrenal cortical carcinoma and adenoma

Coulter, CL, Smith, RE, Stowasser, M, Sasano, H, Krozowski, ZS and Gordon, RD (1998). Expression of 11 beta HSD-2 in human adrenal cortical carcinoma and adenoma. Endocrine Research, 24 (3-4), 875-876.

Expression of 11 beta HSD-2 in human adrenal cortical carcinoma and adenoma

Funding

Current funding

  • 2023 - 2027
    The CONSEP trial: Implementing screening for a hidden cause of hypertension (2021 MRFF CTA led by Monash University)
    Monash University
    Open grant
  • 2011 - 2030
    Causes, diagnosis and management of hypertension in its various forms
    The Irene Patricia Hunt Memorial Trust
    Open grant

Past funding

  • 2020 - 2023
    Screening for Primary Aldosteronism: Outcomes, Economics and Biomarkers (NHMRC Ideas Grant led by Monash University)
    Monash University
    Open grant
  • 2019 - 2021
    Defining the Novel Effects of Mineralocorticoid Receptor Antagonism on Adiposity and Glucose Homeostatis - A Randomised Controlled Trial
    Diabetes Australia Research Program
    Open grant
  • 2018 - 2023
    Potassium in Hypertension
    Fondation Leducq
    Open grant
  • 2015 - 2017
    A novel approach to streamlining the diagnosis of primary aldosteronism
    NHMRC Project Grant
    Open grant
  • 2014
    High throughput gene expression of patient samples via the Nanostring nCounter system
    UQ Major Equipment and Infrastructure
    Open grant
  • 2013
    Genetic basis of primary aldosteronism as a potentially curable form of hypertension
    PA Research Foundation
    Open grant
  • 2013 - 2017
    Targeted LOWering of Central Blood Pressure in patients with hypertension: a randomised controlled trial (The LOW CBP study) NHMRC Project Grant administered by University of Tasmania
    University of Tasmania
    Open grant
  • 2012
    Elucidating genetic mechanisms responsible for familial hyperaldosteronism type II
    PA Research Foundation Private Practice Trust Fund Research Support Grants
    Open grant
  • 2012 - 2013
    Finding better ways to detect curable hypertension
    PA Research Foundation Private Practice Trust Fund Research Support Grants
    Open grant
  • 2011 - 2012
    Effect of adrenalectomy and spironolactone in the severity of obstructive sleep apnoea in patients with primary aldosteronism
    Princess Alexandra Hospital R&D Foundation
    Open grant
  • 2010 - 2013
    Elucidating genetic mechanisms responsible for familial hyperaldosteronism type II
    NHMRC Project Grant
    Open grant
  • 2009 - 2012
    Mayne Bequest Fund Research Support Award: Clinical, pathological and genetic aspects of primary aldosteronism
    Mayne Bequest Fund
    Open grant
  • 2009 - 2010
    Elucidating genetic mechanisms responsible for familial hyperaldosteronism type II
    UQ External Support Enabling Grant
    Open grant
  • 2009 - 2012
    Value of central Blood Pressure for GUIDing managEment of hypertension (BP GUIDE Study)
    NHMRC Project Grant
    Open grant
  • 2008 - 2009
    Elucidating genetic mechanisms responsible for familial hyperaldosteronism type II
    The Endocrine Society (USA)
    Open grant
  • 2007
    Genetics of Primary aldosteronism
    PA Research Foundation
    Open grant
  • 2006 - 2008
    Trial of Aldosterone Blockade and Exercise Training for the Treatment of Exercise Intolerance in Hypertensive Heart Disease
    National Heart Foundation of Australia
    Open grant
  • 2005 - 2007
    Genetics of Primary Aldosteronism
    NHMRC Project Grant
    Open grant
  • 2005
    PAHF block funding
    PA Research Foundation
    Open grant
  • 2003 - 2007
    Centre of Clinical Research Excellence in Cardiovascular Disease and Metabolic Disorders
    NHMRC Research Centre Grant
    Open grant
  • 2002 - 2003
    Biochemical, structural and functional effects of treating fibrosis in hypertensive heart disease
    National Heart Foundation of Australia
    Open grant
  • 2002 - 2003
    Non-BP dependent adverse cardiovascular effects and genetic aspects of aldosterone excess
    National Heart Foundation of Australia
    Open grant
  • 2001 - 2002
    Investigation of the role of the renin-angiotensin system in hepatic fibrosis
    Mayne Bequest Fund
    Open grant
  • 2001 - 2002
    Genetic and therapeutic aspects of familial forms of primary aldosteronism
    Viertel Foundation (Sylvia and Charles Viertel)
    Open grant
  • 2001
    Genetic studies into familial forms of primary aldosteronism
    Princess Alexandra Hospital R&D Foundation
    Open grant
  • 2000 - 2001
    Genetic and phenotypic aspects of familial forms of primary aldosteronism
    UQ New Staff Research Start-Up Fund
    Open grant
  • 2000 - 2001
    Genetic and therapeutic aspects of familial hyperaldosteronism types I and II
    National Heart Foundation of Australia
    Open grant
  • 2000
    The Irene Hunt Hypertension Research Project(s)
    The Irene Patricia Hunt Memorial Trust
    Open grant
  • 1998 - 1999
    Genetic Factors Influencing Aldosterone Biosynthesis and Phenotypic Expression in FH-I
    National Heart Foundation of Australia
    Open grant
  • 1998
    Genetic Factors Influencing Aldosterone Biosynthesis and Phenotypic Expression in PH-1
    Mayne Bequest Fund
    Open grant
  • 1998 - 1999
    Molecular Biology of Familial Hyperaldosteronism Type II
    National Heart Foundation of Australia
    Open grant
  • 1997
    Contribution by wild type and hybrid genes to aldosterone biosynthesis in FH-I
    Mayne Bequest Fund
    Open grant
  • 1996
    Curable hypertension in veterans and others attending Greenslopes Hospital
    Department of Veterans' Affairs
    Open grant
  • 1996 - 1997
    Genetic basis of variable biochemical and clinical phenotypes in familial hyperaldosteronism Type 1
    National Heart Foundation of Australia
    Open grant
  • 1995 - 1997
    An Australian Register for familial hyperaldosteronism - Fellowship
    National Heart Foundation of Australia
    Open grant

Supervision

Availability

Professor Michael Stowasser is:
Available for supervision

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Supervision history

Current supervision

  • Doctor Philosophy

    Defining The Role Of Mineralocorticoid Receptor In Cardiometabolic Health & Inflammation & Optimising The Diagnostic Approach For Aldosterone-producing Adenoma

    Principal Advisor

    Other advisors: Dr Moe Thuzar

Completed supervision

Media

Enquiries

Contact Professor Michael Stowasser directly for media enquiries about:

  • Aldosteronism - primary
  • Cardiac irregularities
  • High blood pressure
  • Hyperaldosteronism
  • Hypertension
  • Hypertension - familial forms
  • Pathophysiology
  • Phaeochromolytoma
  • Renal artery sterosis

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