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Treatment of primary hyperaldosteronism.
Med Clin (Barc). 2020 10 09; 155(7):302-308.MC

Abstract

Primary aldosteronism is associated with higher cardiovascular and renal morbidity and mortality than essential hypertension in age- and sex-matched patients with the same degree of blood pressure elevation. Therefore, it is essential to establish a specific treatment to avoid the deleterious effects of aldosterone excess. Although adrenalectomy is generally considered the treatment of choice in cases of primary aldosteronism due to unilateral disease, several aspects and circumstances should be taken into account that may make medical treatment more appropriate. Among them, in this review we mention the limited experience and efficacy, and the potential risks of adrenal vein sampling; the risks and low efficacy of adrenalectomy; the high safety and efficacy of medical treatment and some special situations such as primary aldosteronism during pregnancy, in patients of advanced age or hereditary forms of primary aldosteronism, in which medical treatment is considered especially indicated as the first line therapy. The main studies comparing medical and surgical treatment in primary aldosteronism are also discussed.

Authors+Show Affiliations

Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: marta.araujo@salud.madrid.org.

Pub Type(s)

Journal Article
Review

Language

eng spa

PubMed ID

32586668

Citation

Araujo-Castro, Marta. "Treatment of Primary Hyperaldosteronism." Medicina Clinica, vol. 155, no. 7, 2020, pp. 302-308.
Araujo-Castro M. Treatment of primary hyperaldosteronism. Med Clin (Barc). 2020;155(7):302-308.
Araujo-Castro, M. (2020). Treatment of primary hyperaldosteronism. Medicina Clinica, 155(7), 302-308. https://doi.org/10.1016/j.medcli.2020.04.029
Araujo-Castro M. Treatment of Primary Hyperaldosteronism. Med Clin (Barc). 2020 10 9;155(7):302-308. PubMed PMID: 32586668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of primary hyperaldosteronism. A1 - Araujo-Castro,Marta, Y1 - 2020/06/23/ PY - 2020/03/25/received PY - 2020/04/27/revised PY - 2020/04/29/accepted PY - 2020/6/27/pubmed PY - 2021/5/15/medline PY - 2020/6/27/entrez KW - Adrenal vein sampling KW - Adrenalectomy KW - Adrenalectomía KW - Cateterismo de venas adrenales KW - Eplerenona KW - Eplerenone KW - Espironolactona KW - Hiperaldosteronismo primario KW - Primary hyperaldosteronism KW - Spironolactone SP - 302 EP - 308 JF - Medicina clinica JO - Med Clin (Barc) VL - 155 IS - 7 N2 - Primary aldosteronism is associated with higher cardiovascular and renal morbidity and mortality than essential hypertension in age- and sex-matched patients with the same degree of blood pressure elevation. Therefore, it is essential to establish a specific treatment to avoid the deleterious effects of aldosterone excess. Although adrenalectomy is generally considered the treatment of choice in cases of primary aldosteronism due to unilateral disease, several aspects and circumstances should be taken into account that may make medical treatment more appropriate. Among them, in this review we mention the limited experience and efficacy, and the potential risks of adrenal vein sampling; the risks and low efficacy of adrenalectomy; the high safety and efficacy of medical treatment and some special situations such as primary aldosteronism during pregnancy, in patients of advanced age or hereditary forms of primary aldosteronism, in which medical treatment is considered especially indicated as the first line therapy. The main studies comparing medical and surgical treatment in primary aldosteronism are also discussed. SN - 1578-8989 UR - https://www.unboundmedicine.com/medline/citation/32586668/Treatment_of_primary_hyperaldosteronism_ DB - PRIME DP - Unbound Medicine ER -