Why should I treat primary aldosteronism?

Physicians are usually taught that less than 1% of patients with essential hypertension have primary aldosteronism. Not only is primary aldosteronism the most common cause of secondary hypertension, its prevalence is in fact so high that it is now believed to be a primary cause of essential hypertension. People with primary aldosteronism have a considerably higher cardiovascular risk profile,  and experience higher rates of renal disease and metabolic disorders. Untreated patients with primary aldosteronism have more serious disease and die much younger than patients with essential hypertension, even if their blood pressure is well controlled. These problems can be mitigated if patients are diagnosed and treated early.

Most cases (60%) present with bilateral disease, and should be treated with dietary sodium restriction and mineralocorticoid receptor antagonists (Spironolactone or Eplerenone), while most of the remaining cases (35%) present with unilateral disease and should undergo adrenalectomy.

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