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Guidelines Set for Management of Primary Aldosteronism

Diagnosis should be targeted to high-risk groups and treated with medication or surgery

FRIDAY, Sept. 5 (HealthDay News) -- Diagnosis of primary aldosteronism, a group of disorders where aldosterone levels are inappropriately high, should be targeted to high-risk groups and treated by mineralocorticoid receptor antagonists or surgery, according to guidelines published in the September issue of the Journal of Clinical Endocrinology & Metabolism.

John W. Funder, M.D., Ph.D., from Prince Henry's Institute of Medical Research in Clayton, Australia, and colleagues reviewed the current evidence to develop clinical practice guidelines for the treatment and diagnosis of primary aldosteronism.

The researchers recommend that higher-risk groups of hypertensive patients and those with hypokalemia should be tested by determining the aldosterone-renin ratio and confirming or excluding a diagnosis by one of four commonly used tests. All patients with primary aldosteronism should undergo adrenal computed tomography to determine the subtype and exclude adrenocortical carcinoma, according to the guidelines.

"We recommend the presence of a unilateral form of primary aldosteronism should be established/excluded by bilateral adrenal venous sampling by an experienced radiologist and, where present, optimally treated by laparoscopic adrenalectomy. We recommend that patients with bilateral adrenal hyperplasia, or those unsuitable for surgery, optimally be treated medically by mineralocorticoid receptor antagonists," the authors write.

Several of the study authors report financial relationships with the pharmaceutical industry.

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