How is the appropriate treatment for primary aldosteronism determined?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The appropriate treatment for primary aldosteronism depends on its cause. Although hypertension (HTN) is frequently cured after unilateral adrenalectomy in patients with primary aldosteronism secondary to an adrenal aldosteronoma, the mean HTN cure rate is only 19% after unilateral or even bilateral adrenalectomy in patients with idiopathic adrenal hyperplasia (IAH). Therefore, medical management is the treatment of choice for the IAH variant of primary aldosteronism. (See the chart below.)

Effects of main antihypertensives on the renin-ang Effects of main antihypertensives on the renin-angiotensin system.

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