Medical treatment as an alternative to adrenalectomy in patients with aldosterone-producing adenomas.
Primary aldosteronism (PA) and, in particular, its two commonest subtypes (i.e. idiopathic hyperaldosteronism (IHA) and aldosterone-producing adenoma (APA)) have been recognized as the most common cause of secondary hypertension. While 'conservative' medical treatment with aldosterone receptor antagonists is the therapeutic approach of choice in controlling blood pressure in patients with PA due to IHA, the more invasive (laparoscopic) adrenalectomy seems to be the most suitable therapy for patients with APA. In this review, we focus on the medical approach for the management of APA in cases where surgical excision of the adrenal is not possible.
Karagiannis
Asterios
A
Department of Internal Medicine, Medical School, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Tziomalos
Konstantinos
K
Kakafika
Anna I
AI
Athyros
Vasilios G
VG
Harsoulis
Faidon
F
Mikhailidis
Dimitri P
DP
D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D000450:Aldosterone / Q000378:metabolism; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy / Q000209:etiology; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*
D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone