Medical treatment as an alternative to adrenalectomy in patients with aldosterone-producing adenomas

    1. Dimitri P Mikhailidis 2
    1. 1Second Propedeutic Department of Internal Medicine, Medical School, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece2Department of Clinical Biochemistry (Vascular Prevention Clinic), Royal Free Hospital Campus, University College London (UCL), Pond Street, London NW3 2QG, UK
    1. (Correspondence should be addressed to D P Mikhailidis; Email: mikhailidis{at}


    Primary aldosteronism (PA) and, in particular, its two commonest subtypes (i.e. idiopathic hyperaldosteronism (IHA) and aldosterone-producing adenoma (APA)) have been recognized as the most common cause of secondary hypertension. While ‘conservative’ medical treatment with aldosterone receptor antagonists is the therapeutic approach of choice in controlling blood pressure in patients with PA due to IHA, the more invasive (laparoscopic) adrenalectomy seems to be the most suitable therapy for patients with APA. In this review, we focus on the medical approach for the management of APA in cases where surgical excision of the adrenal is not possible.

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