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Title: Endocrine Society Releases Guideline on Diagnosis, Treatment of Primary Aldosteronism
URL: http://www.pslgroup.com/dg/22A1DE.htm
Doctor's Guide
August 28, 2008

CHEVY CHASE, Md -- August 28, 2008 -- The Endocrine Society has released a new clinical practice guideline for the detection, diagnosis, and treatment of patients with primary aldosteronism (PA). The guidelines appear in the September issue of the Journal of Clinical Endocrinology & Metabolism.

"Studies show primary aldosteronism may be more prevalent than previously thought, affecting more than 10% of hypertensive patients," said guideline coauthor John Funder, MD, Prince Henry's Institute of Medical Research, Clayton, Australia.

"The new guideline uses the best available research to help physicians diagnose primary aldosteronism and employ specific treatments that can alleviate the impact of this condition."

The guideline recommends that case detection of PA be sought in higher risk groups of hypertensive patients and those with potassium deficiency by determining the ratio of aldosterone to renin, an enzyme that regulates blood pressure.

If this ratio is elevated, diagnosis should then be confirmed or excluded by commonly used confirmatory tests.

If PA is confirmed, the guideline recommends that patients undergo adrenal computed tomography (CT) to exclude adrenocorticol carcinoma, followed by radiographic lateralisation to determine whether PA is due to unilateral or bilateral oversecretion.

Lateralisation is important because if only 1 of the 2 adrenal glands is responsible for oversecretion PA is best treated by laparoscopic surgery to remove the overproducing adrenal gland. For the bilateral form, medical therapy is the treatment of choice.

When medical therapy is needed, the guideline recommends patients be treated with mineralocorticoid receptor antagonists, drugs which inhibit the action of aldosterone.

SOURCE: The Endocrine Society

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