Endocrine Society Releases Primary Aldosteronism Guideline

The Endocrine Society has released a clinical practice guideline for the management of primary aldosteronism, a common cause of high blood pressure.

Primary aldosteronism frequently goes undiagnosed, although it is quite common. It can lead to uncontrolled high blood pressure and other severe health conditions.
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A task force, which included 7 medical professionals from around the world, was created to construct the guidelines. They examined systemic reviews and primary studies for key treatments and prevention best practices. They then rated the quality of evidence and strength of the recommendations using the Grading of Recommendations, Assessment, Development, and Evaluation criteria.

They included 4 recommendations in the final guideline:

  • To diagnose primary aldosteronism in high-risk patients with hypertension or hypokalemia, use the aldosterone-renin ratio test under standard conditions and recommend that a commonly used confirmatory test should confirm/exclude the condition.
  • All patients diagnosed with primary aldosteronism should undergo adrenal CT scan to screen for adrenocortical carcinoma.
  • An experienced radiologist should determine unilateral primary aldosteronism by using bilateral adrenal venous sampling, and, if confirmed, this should optimally be treated by laparoscopic adrenalectomy.
  • Patients with bilateral adrenal hyperplasia or those unsuitable for surgery should be treated primarily with a mineralocorticoid receptor antagonist.

—Amanda Balbi

Reference:

Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline [published online March 2, 2016]. JCEM. doi:http://dx.doi.org/10.1210/jc.2015-4061.