Primary aldosteronism (PA) is a cause of resistant hypertension and cardiovascular events. Traditional treatments such as medication with mineralocorticoid receptor antagonists and adrenalectomy have some limitations. Over the past decade, radiofrequency ablation and arterial embolization have been used to treat aldosterone-producing adenoma, but their efficacies have not been compared with randomized and medication-controlled studies. This study shows that both adrenal ablation and medication can reduce blood pressure in patients with PA, but adrenal ablation can also significantly reduce the defined daily dose and plasma aldosterone concentration. Among the patients treated by adrenal ablation, 81% patients achieved complete/partial hypertension remission plus biochemical improvement. Adrenal ablation did not cause serious procedure-related complications, such as adrenal insufficiency. In contrast, among patients treated with spironolactone, plasma aldosterone levels did not decrease, and adverse effects were common.
