Medical management of aldosterone-producing adenomas.
BACKGROUND
No data are available on the long-term medical management of aldosterone-producing adenomas.


OBJECTIVE
To demonstrate the efficacy of medical management of aldosterone-producing adenomas in terms of blood pressure and serum potassium concentration and to discuss morbidity associated with medical management.


METHODS
Retrospective cohort study.


METHODS
Large tertiary care referral center.


METHODS
24 patients with documented aldosterone-producing adenomas who were treated medically for at least 5 years.


METHODS
Aldosterone excretion rate, plasma renin activity, and size and location of adenomas (by computed tomography). Blood pressure and serum electrolytes were measured at the time of diagnosis and last follow-up.


RESULTS
From the time of diagnosis to the time of last follow-up, systolic blood pressure decreased from 175 mm Hg to 129 mm Hg (95% CI for difference, 37.1 to 53.8 mm Hg) and diastolic blood pressure decreased from 106 mm Hg to 79 mm Hg (CI for difference, 20.8 to 33.9 mm Hg). Serum potassium concentration increased from 3.0 mmol/L to 4.3 mmol/L (CI for difference, 1.1 to 1.5 mmol/L).


CONCLUSIONS
Medical management of aldosterone-producing adenomas is a viable option for controlling blood pressure and serum potassium concentration.
Department of Nephrology and Hypertension, Cleveland Clinic Foundation, Ohio 44195, USA.
R P
RP
Ghose
P M
PM
Hall
E L
EL
Bravo
D000236:Adenoma / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy / Q000209:etiology; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011188:Potassium / Q000097:blood; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use
D000959:Antihypertensive Agents; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D011188:Potassium