Department of Medicine, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Department of Medicine (Division of Nephrology) and the Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Front Endocrinol (Lausanne). 2022 Apr 26;13:861581. doi: 10.3389/fendo.2022.861581. eCollection 2022.
Primary aldosteronism is the most common and modifiable form of secondary hypertension. Left untreated, primary aldosteronism leads high rates of cardiovascular, metabolic, and kidney disease. Therefore, early diagnosis and targeted therapy are crucial to improve long-term patient outcomes. In the case of unilateral primary aldosteronism, surgical adrenalectomy is the guideline-recommended treatment of choice as compared to alternative medical therapies such as mineralocorticoid receptor antagonist medications. Surgical adrenalectomy is not only highly successful in reversing the biochemical abnormalities inherent to primary aldosteronism, but also in mitigating the long-term risks associated with this disease. Indeed, as opposed to medical treatment alone, surgical adrenalectomy offers the potential for disease cure. Within this review article, we review the existing evidence highlighting the benefits of surgical over medical treatment for unilateral primary aldosteronism.
原发性醛固酮增多症是最常见和可治疗的继发性高血压形式。未经治疗,原发性醛固酮增多症会导致心血管、代谢和肾脏疾病的高发病率。因此,早期诊断和靶向治疗对于改善长期患者预后至关重要。在单侧原发性醛固酮增多症的情况下,与盐皮质激素受体拮抗剂等替代药物治疗相比,手术肾上腺切除术是指南推荐的首选治疗方法。手术肾上腺切除术不仅在逆转原发性醛固酮增多症固有的生化异常方面非常成功,而且在减轻与这种疾病相关的长期风险方面也非常成功。事实上,与单纯药物治疗相比,手术肾上腺切除术有治愈疾病的可能。在这篇综述文章中,我们回顾了现有的证据,强调了手术治疗优于药物治疗单侧原发性醛固酮增多症的益处。