Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 16;27(1):4.
doi: 10.1007/s11906-024-01319-y.

Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications

Zhichao Dong #  1 , Xiaoxiao Song #  2 , Minyue Jia  3 , Jinliang Chen  2 , Yuhao Zhang  2 , Hanxiao Yu  4 , Yongli Ji  2 , Lizhen Shan  2 , Tianyue Zhang  2 , Chao Zheng  5 , Jiaming Wen  6 , Xiaohong Xu  7
Affiliations
Review

Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications

Zhichao Dong et al. Curr Hypertens Rep. .

Abstract

Purpose of review: One of the challenges in the diagnosis and management of primary aldosteronism (PA), the most common type of secondary hypertension with curative potential, is the modification of antihypertensive medications. We seek to explore whether these medications can be continued during the diagnostic process of PA to minimize the duration and risks associated with medication adjustments.

Recent findings: We searched PubMed for eligible original literature between 1990 and 2024 using the following keywords: (screening) AND (primary aldosteronism); (confirmatory) AND (primary aldosteronism); (adrenal vein sampling) AND primary aldosteronism). Some recent studies support the feasibility of PA-related tests and even adrenal vein sampling (AVS) without the need to discontinue antihypertensive medications in certain cases. In this review, we propose a management approach that considers the specific effects of antihypertensive medications on the RAAS axis and the patient's disease phenotype. Based on this, we suggest a strategy that enables the diagnosis of PA in certain patients without discontinuing their antihypertensive medications.

Keywords: Adrenal vein sampling; Aldosterone; Aldosterone to renin ratio; Primary aldosteronism; Renin.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Xu Z, Yang J, Hu J, et al. Primary aldosteronism in patients in China with recently detected hypertension. J Am Coll Cardiol. 2020;75(16):1913–22. https://doi.org/10.1016/j.jacc.2020.02.052 . - DOI - PubMed
    1. Monticone S, Burrello J, Tizzani D, et al. Prevalence and clinical manifestations of primary Aldosteronism encountered in primary care practice. J Am Coll Cardiol. 2017;69(14):1811–20. https://doi.org/10.1016/j.jacc.2017.01.052 . - DOI - PubMed
    1. Brown M, Siddiqui J, Calhoun MA et al. D,. The Unrecognized Prevalence of Primary Aldosteronism. Ann Intern Med. Published online May 26, 2020. https://doi.org/10.7326/M20-0065
    1. Milliez P, Girerd X, Plouin PF, Blacher J, Safar ME, Mourad JJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol. 2005;45(8):1243–8. https://doi.org/10.1016/j.jacc.2005.01.015 . - DOI - PubMed
    1. Monticone S, D’Ascenzo F, Moretti C, et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018;6(1):41–50. https://doi.org/10.1016/S2213-8587(17)30319-4 . - DOI - PubMed

MeSH terms

Substances

LinkOut - more resources