Which medications are indicated in the treatment of aldosteronism and heart failure, and how does treatment of primary aldosteronism affect insulin response?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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In patients with heart failure who have secondary aldosteronism, aldosterone antagonism by spironolactone and eplerenone has been demonstrated to confer survival benefit. [42, 43]

A prospective study by Adler et al indicated that treatment of primary aldosteronism, either by adrenalectomy or mineralocorticoid antagonist, causes an increase in the insulin response to glucose, as well as a decrease in insulin clearance. Moreover, according to the investigators, this phenomenon does not result from changes in creatinine clearance or plasma cortisol. [44]

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