Effect of short-term losartan treatment in patients with primary
aldosteronism and essential hypertension

Zacharieva, Sabina; Atanassova, Iliana; Natchev, Еmil; Orbetzova, Maria; Tzingilev, D

doi:10.1358/mf.2001.23.3.627950

Cited by 4 publications

(2 citation statements)

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“…76 However, ARBs may be beneficial in some patients with bilateral hyperplasia or angiotensin-responsive adenoma. 77,78 Finerenone, a new non-steroidal and highly potent MRA, has been studied in patients with chronic heart failure and mild CKD; it seems to decrease BNP and albuminuria as efficiently as spironolactone. 79,80 Aldosterone synthase inhibitors are currently in clinical development.…”

Section: Drug-based Treatment For Pamentioning

confidence: 99%

Outcomes of Drug-Based and Surgical Treatments for Primary Aldosteronism

Steichen

Lorthioir

Zinzindohoué

et al. 2015

Advances in Chronic Kidney Disease

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Treatments for primary aldosteronism (PA) aim to correct or prevent the deleterious consequences of hyperaldosteronism: hypertension, hypokalemia and direct target organ damage. Patients with unilateral PA considered fit for surgery can undergo laparoscopic adrenalectomy, which significantly decreases blood pressure and medications in most cases, and cures hypertension in about 40%. Mineralocorticoid receptor antagonists (MRA) are used to treat patients with bilateral PA and those with unilateral PA if surgery is not possible or not desired. Spironolactone is more potent than eplerenone, but high doses are poorly tolerated in men. MRA can be replaced or complemented with epithelial sodium channel blockers, such as amiloride. Thiazide diuretics and calcium channel blockers are used when the first-line drugs are insufficient to control blood pressure. Dietary sodium restriction should be implemented in all cases, because the deleterious consequences of hyperaldosteronism are dependent on salt loading. Several studies comparing the results of surgery and MRA have reported no differences in terms of blood pressure, serum potassium concentration or cardiovascular and renal outcomes, although the benefits of treatment tend to be observed sooner with surgery.PA patients display relative glomerular hyperfiltration, which is reversed by specific treatment, revealing chronic kidney disease in 30% of patients. However, further kidney damage is prevented by the treatment of PA. Clinical summary-The goals of treatment are the normalization of serum potassium concentration, blood pressure control and prevention of the direct effects of excess aldosterone on target organs. 3-The non-surgical treatment of PA is based on mineralocorticoid receptor antagonists and dietary sodium restriction.-Epithelial sodium channel blockers are used when mineralocorticoid receptor antagonists are not well tolerated; thiazide diuretics and calcium channel blockers are used when blood pressure control is insufficient with the first-line treatment.-Laparoscopic adrenalectomy is safe and decreases BP and medication requirements in patients with unilateral PA; drug-based treatments are appropriate in cases in which surgery is inappropriate or not desired.

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Section: Drug-based Treatment For Pamentioning

confidence: 99%

Outcomes of Drug-Based and Surgical Treatments for Primary Aldosteronism

Steichen

Lorthioir

Zinzindohoué

et al. 2015

Advances in Chronic Kidney Disease

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“…Anti-hypertensive agents such as angiotensin-converting enzyme inhibitors [84], angiotensin receptor blockers [85] and calcium channel blockers [86] have been evaluated in few patients with PA without major effect on aldosterone excess. Aldosterone synthase inhibitors may play a role in future.…”

Section: Other Agentsmentioning

confidence: 99%

Primary aldosteronism: from bench to bedside

Sukor

2011

Endocrine

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Primary aldosteronism is now thought to be the commonest potentially curable and specifically treatable form of hypertension. The detection of primary aldosteronism is of utmost importance not only because it provides an opportunity for a targeted treatment, but also because it has been demonstrated that patients with primary aldosteronism are more prone to cardiovascular events and target organ damage than essential hypertensives. Normalization of blood pressure and hypokalemia should not be the only goal of treatment. Normalization of circulating aldosterone or mineralocorticoid blockade is necessary to prevent aldosterone-induced tissue damage that occurs independent of blood pressure. This review will focus on the current understanding and comprehensive management review of primary aldosteronism, highlighting the new evidence that has become recently available.

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Endocrine hypertension — Current understanding and comprehensive management review

Sukor

2011

European Journal of Internal Medicine

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Effect of short-term losartan treatment in patients with primary aldosteronism and essential hypertension

Cited by 4 publications

References 0 publications

Outcomes of Drug-Based and Surgical Treatments for Primary Aldosteronism

Outcomes of Drug-Based and Surgical Treatments for Primary Aldosteronism

Primary aldosteronism: from bench to bedside

Endocrine hypertension — Current understanding and comprehensive management review

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