Preview

Problems of Endocrinology

Advanced search

The treatment of primary hyperaldosteronism

https://doi.org/10.14341/probl201056341-46

Abstract

The present review deals with the treatment of main nosological forms of primary hyperaldosteronism, such as aldosteron-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Much attention is given to perioperative management of APA patients for whom surgical treatment is the method of choice. Idiopathic hyperaldosteronism characterized by bilateral macro- and micronodular changes dictates the necessity of medicamentous therapy, in the first place with antagonists of mi­neralocorticoid receptors (e.g. spironolactone). Pharmacological standards of drug therapy are described for patients with IHA and those with APA in whom surgical treatment is impracticable.

References

1. Conn J.W. Presidential address. Part I. Painting background.Part II. Primary aldosteronism, a new clinical syndrome. J Lab Clin Med 1955;45:3-17.

2. Арабидзе Г.Г., Чихладзе Н.М. Альдостерома (синдром Конна). Кардиология 1991;12:90-95.

3. Калинин А.П., Майстренко Н.А. Хирургия надпочечников. М: Медицина 2000.

4. Blumenfeld J.D., Sealey J.E., Schlussel Y. et al. Diagnosis and treatment of primary hyperaldosteronism. Ann Int Med 1994;121:877-885.

5. Harris D.A., Au-Yong I., Basnyat P.S. et al. Review of surgical management of aldosterone secreting tumours of the adrenal cortex. Eur J Surg Oncol 2003;29:467-474.

6. Rossi H., Kim A., Prinz R.A. Primary hyperaldosteronism in the era of laparoscopic adrenalectomy. Am Surg 2002;68:253-256; discussion 256-257.

7. Sawka A.M., Young W.F., Thompson G.B. et al. Primary aldosteronism: factors associated with normalization of blood pressure after surgery. Ann Int Med 2001;135:258-2561.

8. Stowasser M., Klemm S.A., Tunny T.J. et al. Response to unilateral adrenalectomy for aldosterone-producing adenoma: effect of potassium levels and angiotensin responsiveness. Clin Exp Pharmacol Physiol 1994;21:319-322.

9. Young W.F., Jr. Minireview: primary aldosteronism-changing concepts in diagnosis and treatment. Endocrinology 2003;144:2208-2213.

10. Калинин А.П., Майстренко Н.А. Хирургия надпочечников. М: Медицина 2000.

11. Meyer A., Brabant G., Behrend M. Long-term follow-up after adrenalectomy for primary aldosteronism. World J Surg 2005;29:155-159.

12. Celen O., O'Brien M.J., Melby J.C., Beazley R.M. Factors influencing outcome of surgery for primary aldosteronism. Arch Surg 1996;131:646-650.

13. Lo C.Y., Tam P.C., Kung A.W. et al. Primary aldosteronism. Results of surgical treatment. Ann Surg 1996;224:125-130.

14. Proye C.A., Mulliez E.A., Carnaille B.M. et al. Essential hypertension: first reason for persistent hypertension after unilateral adrenalectomy for primary aldosteronism? Surgery 1998;124:1128-1133.

15. Saruta T., Suzuki H., Takita T. et al. Pre-operative evaluation of the prognosis of hypertension in primary aldosteronism owing to adenoma. Acta Endocrinol 1987;116:229-234.

16. Jacobsen N.E., Campbell J.B., Hobart M.G. Laparoscopic versus open adrenalectomy for surgical adrenal disease. Can J Urol 2003;10:1995-1999.

17. Rutherford J.C., Stowasser M., Tunny T.J. et al. Laparoscopic adrenalectomy. World J Surg 1996;20:758-760; discussion 761.

18. Mattsson C., Young W.F., Jr. Primary aldosteronism: diagnostic and treatment strategies. Nat Clin Pract Nephrol 2006;2:198-208.

19. Rutherford J.C., Taylor W.L., Stowasser M., Gordon R.D. Success of surgery for primary aldosteronism judged by residual autonomous aldosterone production. World J Surg 1998;22:1243-1245.

20. Brown J.J., Davies D.L., Ferriss J.B. et al. Comparison of surgery and prolonged spironolactone therapy in patients with hypertension, aldosterone excess, and low plasma renin. Br Med J 1972;2:729-734.

21. Ferriss J.B., Beevers D.G., Boddy K. et al. The treatment of low-renin (‘primary') hyperaldosteronism. Am Heart J 1978;96:97-109.

22. Biglieri E.G. & Schambelan M. Management of primary aldosteronism. In: Hypertension: Mechanisms and Management. Eds. G. Onesti, K.E. Kim & J.H. Moyer. New York: Grune and Stratton 1973;493-498.

23. Ghose R.P., Hall P.M., Bravo E.L. Medical management of aldosterone-producing adenomas. Ann Int Med 1999;131:105-108.

24. Sywak M., Pasieka J.L. Long-term follow-up and cost benefit of adrenalectomy in patients with primary hyperaldosteronism. Br J Surg 2002;89:1587-1593.

25. Gunnells J.C., Jr., Bath N.M., Sode J., Robinson R.R. Primary aldosteronism. Arch Int Med 1967;120:568-574.

26. Priestley J.T., Ferris D.O., ReMine W.H., Woolner L.B. Primary aldosteronism: surgical management and pathologic findings. Mayo Clin Proc 1968;43:761-775.

27. Rhamy R.K., McCoy R.M., Scott H.W., Jr. et al. Primary aldosteronism: experience with current diagnostic criteria and surgical treatment in fourteen patients. Ann Surg 1968;167:718-727.

28. Weinberger M.H., Grim C.E., Hollifield J.W. et al. Primary aldosteronism: diagnosis, localization, and treatment. Ann Int Med 1979;90:386-395.

29. Young W.F. Primary aldosteronism: renaissance of a syndrome. Clin Endocrinol (Oxf) 2007;66:607-618.

30. Jeunemaitre X., Chatellier G., Kreft-Jais C. et al. Efficacy and tolerance of spironolactone in essential hypertension. Am J Cardiol 1987;60:820-825.

31. Crane M.G., Harris J.J. Effect of spironolactone in hypertensive patients. Am J Med Sci 1970;260:311-330.

32. Ganguly A., Luetscher J.A. Spironolactone therapy in primary aldosteronism:diagnostic and therapeutic implications. In: Systemic effects of antihypertensive agents. Ed. M.P. Sambhi. New York: Stratton 1976;383-392.

33. Helber A., Wambach G., Hummerich W. Evidence for a subgroup of essential hypertensives with non-suppressible excretion of aldosterone during sodium loading. Klin Wochenschr 1980;58:439-447.

34. Kater C.E., Biglieri E.G., Schambelan M., Arteaga E. Studies of impaired aldosterone response to spironolactone-induced renin and potassium elevations in adenomatous but not hyperplastic primary aldosteronism. Hypertension 1983;5:115-121.

35. Kremer D., Beevers D.G., Brown J.J. et al. Spironolactone and amiloride in the treatment of low rennin hyperaldosteronism and related syndromes. Clin Sci Mol Med 1973;45:Suppl 1:213-218.

36. Wambach G., Helber A., Bonner G. et al. Spironolactone in essential hypertension associated with abnormal aldosterone regulation and in Conns syndrome (authors transl.). Dtsch Med Wochenschr 1980;105:647-651.

37. Mantero F., Opocher G., Rocco S. et al. Long-term treatment of mineralocorticoid excess syndromes. Steroids 1995;60:81-86.

38. Armanini D., Karbowiak I., Goi A. et al. In vivo metabolites of spironolactone and potassium canrenoate: determination of potential anti-androgenic activity by a mouse kidney cytosol receptor assay. Clin Endocrinol 1985;23:341-347.

39. Dupont A. Disappearance of spironolactone-induced gynaecomastia during treatment with potassium canrenoate. Lancet 1985;2:731.

40. Garthwaite S.M .& McMahon E.G. The evolution of aldosterone antagonists. Mol Cel Endocrinol 2004;217:27-31.

41. Pitt B., Remme W., Zannad F. et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309-1321.

42. Karagiannis A., Tziomalos K., Papageorgiou A. et al. Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin Pharmacother 2008;9:509-515.

43. Eide I.K., Torjesen P.A., Drolsum A. Low-renin status in therapy-resistant hypertension: a clue to efficient treatment. J Hypertens 2004;22:2217-2226.

44. Lim P.O., Young W.F., MacDonald T.M. A review of the medical treatment of primary aldosteronism. J Hypertens 2001;19:353-361.

45. Farquharson C.A., Struthers A.D. Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000;101:594-597.

46. Farquharson C.A., Struthers A.D. Increasing plasma potassium with amiloride shortens the QT interval and reduces ventricular extrasystoles but does not change endothelial function or heart rate variability in chronic heart failure. Heart 2002;88:475.

47. Brown M.J., Hopper R.V. Calcium-channel blockade can mask the diagnosis of Conn's syndrome. Postgraduate Med J 1999;75:235-236.

48. Stimpel M., Ivens K., Wambach G. & Kaufmann W. Are calcium antagonists helpful in the management of primary aldosteronism? J Cardiovasc Pharmacol 1988;12:S131-S134.

49. Veglio F., Pinna G., Bisbocci D. et al. Efficacy of nicardipine slow release (SR) on hypertension, potassium balance and plasma aldosterone in idiopathic aldosteronism. J Hum Hypertens 1990;4:579-582.

50. Griffing G.T. & Melby J.C. The therapeutic effect of a new angiotensin-converting enzyme inhibitor, enalapril maleate, in idiopathic hyperaldosteronism. J Clin Hypertens 1985;1:265-276.

51. Mantero F., Fallo F., Opocher G. et al. Effect of angiotensin II and converting enzyme inhibitor (captopril) on blood pressure, plasma renin activity and aldosterone in primary aldosteronism. Clin Sci 1981;61:289s-293s.

52. Wisgerhof M., Carpenter P.C., Brown R.D. Increased adrenal sensitivity to angiotensin II in idiopathic hyperaldosteronism. J Clin Endocrinol Metab 1978;47:938-943.

53. Stowasser M., Klemm S.A., Tunny T.J. et al. Response to unilateral adrenalectomy for aldosterone-producing adenoma: effect of potassium levels and angiotensin responsiveness. Clin Exp Pharmacol Physiol 1994;21:319-322.

54. Curnow K.M., Tusie-Luna M.T., Pascoe L. et al. The product of the CYP11B2 gene is required for aldosterone biosynthesis in the human adrenal cortex. Mol Endocrinol 1991;5:1513-1522.

55. Mulatero P., Morello F., Veglio F. Genetics of primary aldosteronism. J Hypertens 2004;22:663-670.

56. Ménard J., Gonzalez M.F., Guyene T.T., Bissery A. Investigation of aldosterone-synthase inhibition in rats. J Hypertens 2006;24:1147-1155.

57. Silvestre J.S., Robert V., Heymes C. et al. Myocardial production of aldosterone and corticosterone in the rat. Physiological regulation. J Biol Chem 1998;273:4883-4891.

58. Takeda Y., Miyamori I., Inaba S. et al. Vascular aldosterone in genetically hypertensive rats. Hypertension 1997;29:45-48.

59. Ahmad N., Romero D.G., Gomez-Sanchez E.P., Gomez-Sanchez C.E. Do human vascular endothelial cells produce aldosterone? Endocrinology 2004;145:3626-3629.

60. Fiebeler A., Nussberger J., Shagdarsuren E. et al. Aldosterone synthase inhibitor ameliorates angiotensin II-induced organ damage. Circulation 2005;111:3087-3094.

61. Brand E., Chatelain N., Mulatero P. et al. Structural analysis and evaluation of the aldosterone synthase gene in hypertension. Hypertension 1998;32:198-204.

62. Taymans S.E., Pack S., Pak E. et al. Human CYP11B2 (aldosterone synthase) maps to chromosome 8q24.3. J Clin Endocrinol Metab 1998;83:1033-1036.


Review

For citations:


Fadeev V.V., Bel'tsevich D.G., Rogal' E.I., Molashenko N.V., Mel'nichenko G.A. The treatment of primary hyperaldosteronism. Problems of Endocrinology. 2010;56(3):41-46. https://doi.org/10.14341/probl201056341-46

Views: 564


ISSN 0375-9660 (Print)
ISSN 2308-1430 (Online)