Treatment effects in primary hyperaldosteronism

Abstract

Background Primary aldosteronism is the syndrome resulting from the autonomous hypersecretion of aldosterone. There is a lack of data concerning follow-up of patients with primary aldosteronism. Therefore, the aim of the study was to perform follow-up of patients with primary aldosteronism in relation to biochemical parameters and target organ damage.
Material and methods We evaluated 62 patients with primary aldosteronism (PA) diagnosed and treated in the Department of Hypertension, Institute of Cardiology, Warsaw, Poland. Clinical characteristics, biochemical, serum aldosterone level, plasma renin activity as well as echocardiographic parameters and blood pressure (ABPM) were evaluated at baseline and in the follow-up. Patients were divided into two group based on the type of underlying pathology and treatment type - adenoma of adrenal cortex (APA) treated surgically and idiopathic adrenal hyperplasia (IHA) treated medically (spironolactone).
Results Surgical treatment of the adenoma of adrenal cortex and medical treatment of idiopathic adrenal hyperplasia resulted in the improvement of BP control. In the follow-up APA group was characterized by lower diastolic BP level but not systolic BP level as compared with IHA group. Left ventricular mass index decreased significantly in the APA group but not in the IHA group. There was a correlation between left ventricular mass index and systolic BP level both in the APA and IHA group.
Conclusions Treatment of both adenoma of adrenal cortex and idiopathic adrenal hyperplasia resulted in the improvement of BP control. Decrease of left ventricular index was observed in patients with adenoma but not in patients with hyperplasia.