Management of primary aldosteronism and mineralocorticoid receptor-associated hypertension

  title={Management of primary aldosteronism and mineralocorticoid receptor-associated hypertension},
  author={Satoshi Morimoto and Atsuhiro Ichihara},
  journal={Hypertension Research},
Resistant hypertension is associated with a poor prognosis due to organ damage caused by prolonged suboptimal blood pressure control. The concomitant use of mineralocorticoid receptor (MR) antagonists with other antihypertensives has been shown to improve blood pressure control in some patients with resistant hypertension, and such patients are considered to have MR-associated hypertension. MR-associated hypertension is classified into two subtypes: one with a high plasma aldosterone level… 
Aldosterone breakthrough from a pharmacological perspective
  • M. Mogi
  • Biology, Medicine
    Hypertension Research
  • 2022
This review discusses Aldo secretion and the mechanism of Aldo breakthrough, dependent or independent of the RAAS, with consideration of the pharmacological aspects of this phenomenon, as well as hypothetical views.
Practice Recommendations for Diagnosis and Treatment of the Most Common Forms of Secondary Hypertension
The aim of this minireview is to provide updated concise information on the screening, diagnosis, and management of the most common forms, including primary aldosteronism, renovascular hypertension, pheochromocytoma and paraganglioma, Cushing’s syndrome, and obstructive sleep apnea.
Characterization of pendrin in urinary extracellular vesicles in a rat model of aldosterone excess and in human primary aldosteronism
Analysis of quantitative changes in pendrin in urinary extracellular vesicles isolated from patients with primary aldosteronism and from a rat model of aldosterone excess indicates that pendrin analysis in uEVs, along with other proteins, can be useful to understand the pathophysiology of hypertensive disorders.
Lysine-specific demethylase 1 as a corepressor of mineralocorticoid receptor
In vitro and in vivo studies demonstrated that LSD1 is a newly identified corepressor of MR, demonstrating the functions of LSD1 as a coregulator of MR.
Albino male rats were divided randomly into four equal groups and treated for 90 days as following and blood samples were collected directly from the heart and serum samples were isolated to measure sodium, potassium concentration and to estimate renal function.
Hypothalamus-pituitary-adrenal Axis in Glucolipid metabolic disorders
The research progress on drugs for GLMD is reviewed and the direction for exploring new drugs to treat GLMD by taking the HPA axis as the target is provided to improve the level of prevention and control of GLMD.
DNA Methylation of the Angiotensinogen Gene, AGT, and the Aldosterone Synthase Gene, CYP11B2 in Cardiovascular Diseases
Results indicate that epigenetic regulation of both AGT and CYP11B2 contribute to the pathogenesis of cardiovascular diseases.
Concurrent Primary Aldosteronism and Renal Artery Stenosis: An Overlooked Condition Inducing Resistant Hypertension
PA with concurrent severe RAS is a condition that induces RH and RAS patients with RH after successful revascularization for RAS should be evaluated for coexisting PA.


Mineralocorticoid receptor-associated hypertension and its organ damage: clinical relevance for resistant hypertension.
In resistant hypertension, defined as a failure of concomitant use of three or more different classes of antihypertensive agents to control blood pressure, add-on therapy with mineralocorticoid receptor (MR) antagonists is frequently effective, which is designated as "MR-associated hypertension".
Aldosterone-receptor antagonism in hypertension
Prescription of ARAs are recommended to patients with primary aldosteronism, resistant hypertension and patients with hypertension and hypokalemia on the basis of the current knowledge.
Renal Outcomes in Medically and Surgically Treated Primary Aldosteronism
A retrospective cohort study of patients with PA treated with MRAs or surgical adrenalectomy and age- and estimated glomerular filtration rate–matched patients with essential hypertension to determine risk for chronic kidney disease and longitudinal estimated glomersular filTration rate decline finds that curative surgical Adrenalectomy may be superior to lifelong MRA therapy in preventing kidney disease in PA.
Mineralocorticoid receptor activation and blockade: an emerging paradigm in chronic kidney disease.
The results reported in experimental and clinical research in this field are discussed, and the direct activation of the MR that can occur in pathological states associated with CKD, even in the absence of increased circulating levels of aldosterone is emphasized.
Functional tests for primary aldosteronism: Value of captopril suppression
The captopril suppression test appears as effective as salt loading in confirming a diagnosis of primary aldosteronism and is safe, well tolerated, and cost-effective.
Management of blood pressure in patients with diabetes.
Treatment of patients with diabetes with high blood pressure should be individualized according to concomitant risk factors and diseases and depending on the age and hemodynamic and laboratory parameters of the patient.
Effectiveness of Aldosterone Blockade in Patients With Diabetic Nephropathy
The possibility that aldosterone blockade may represent optimal therapy for patients with early diabetic nephropathy who show ald testosterone escape during ACE inhibitor treatment and who no longer show maximal antiproteinuric effects of ACE inhibition is suggested.
Aldosterone and refractory hypertension: a prospective cohort study.