Journal
ANNALES D ENDOCRINOLOGIE
Volume 77, Issue 3, Pages 226-234Publisher
MASSON EDITEUR
DOI: 10.1016/j.ando.2016.01.010
Keywords
Spironolactone; Amiloride; Eplerenone; Calcic inhibitor; Thiazide diuretic; Primary aldosteronism; Hypertension; Cardiovascular morbidity
Categories
Funding
- AstraZeneka
- MSD
- Novo-Nordisk
- Novartis
- Ipsen
- Sandoz
- Pfizer laboratories
Ask authors/readers for more resources
Spironolactone, which is a potent mineralocorticoid receptor antagonist, represents the first line medical treatment of primary aldosteronism (PA). As spironolactone is also an antagonist of the androgen and progesterone receptor, it may present side effects, especially in male patients. In case of intolerance to spironolactone, amiloride may be used to control hypokaliemia and we suggest that eplerenone, which is a more selective but less powerful antagonist of the mineralocorticoid receptor, be used in case of intolerance to spironolactone and insufficient control of hypertension by amiloride. Specific calcic inhibitors and thiazide diuretics may be used as second or third line therapy. Medical treatment of bilateral forms of PA seem to be as efficient as surgical treatment of lateralized PA for the control of hypertension and the prevention of cardiovascular and renal morbidities. This allows to propose medical treatment of PA to patients with lateralized forms of PA who refuse surgery or to patients with PA who do not want to be explored by adrenal venous sampling to determine whether they have a bilateral or lateralized form. (C) 2016 Elsevier Masson SAS. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available