Academic Journal
Primary Aldosteronism Medical Treatment Outcomes (PAMO) Beyond 12 Months.
| Τίτλος: | Primary Aldosteronism Medical Treatment Outcomes (PAMO) Beyond 12 Months. |
|---|---|
| Συγγραφείς: | Yang J; Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., R.L., P.J.F.).; Department of Medicine, Monash University, Clayton, Victoria, Australia (J.Y.)., Goi J; Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Italy (J.G., J.B., P.M.)., Burrello J; Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Italy (J.G., J.B., P.M.)., Reincke M; Department of Medicine IV, LMU University Hospital, Munich, Germany (M.R., C.A., D.B., T.A.W.)., Adolf C; Department of Medicine IV, LMU University Hospital, Munich, Germany (M.R., C.A., D.B., T.A.W.)., Brüdgam D; Department of Medicine IV, LMU University Hospital, Munich, Germany (M.R., C.A., D.B., T.A.W.)., Li Q; Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, China (Q.L., Y.S., J.H., S.Y.)., Song Y; Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, China (Q.L., Y.S., J.H., S.Y.)., Hu J; Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, China (Q.L., Y.S., J.H., S.Y.)., Yang S; Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, China (Q.L., Y.S., J.H., S.Y.)., Satoh F; Tohoku University Graduate School of Medicine, Sendai, Japan (F.S.)., Ono Y; Division of Nephrology, Rheumatology and Endocrinology, Tohoku University Graduate School of Medicine, Sendai, Japan (Y.O.)., Libianto R; Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., R.L., P.J.F.)., Stowasser M; Endocrine Hypertension Research Centre, University of Queensland, Frazer Institute, Princess Alexandra Hospital, Brisbane, Australia (M.S.)., Li N; Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (N.L., Q.Z.)., Zhu Q; Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (N.L., Q.Z.)., Hong N; Division of Endocrinology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (N.H.)., Nayak D; Metro South Health (Princess Alexandra Hospital), Woolloongabba, Queensland, Australia (D.N.)., Puar TH; Department of Endocrinology, Changi General Hospital, SingHealth, Singapore (T.H.P.)., Wu VC; Nephrology Division, Primary Aldosterone Center, Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan (V.-C.W.)., Vaidya A; Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.V.)., Araujo-Castro M; Endocrinology & Nutrition Department, Ramón y Cajal Hospital, Madrid, Spain (M.A.-C.)., Kocjan T; Department of Endocrinology, Diabetes, and Metabolic Diseases, University Medical Centre Ljubljana, Slovenia (T.K.).; Faculty of Medicine, University of Ljubljana, Slovenia (T.K.)., O'Toole SM; Department of Endocrinology, Royal Hallamshire Hospital, Sheffield, United Kingdom (S.M.O.T.)., Hundemer GL; Division of Nephrology, Department of Medicine, University of Ottawa, ON, Canada (G.L.H.)., Ragnarsson O; Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Sweden (O.R.)., Lacroix A; Centre hospitalier de l'Université de Montréal (CHUM), Canada (A.L., S.L.)., Larose S; Centre hospitalier de l'Université de Montréal (CHUM), Canada (A.L., S.L.)., Nakai K; Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Kanagawa, Japan (K.N., T.N.)., Nishikawa T; Endocrinology and Diabetes Center, Yokohama Rosai Hospital, Kanagawa, Japan (K.N., T.N.)., Ladygina D; Federal State Autonomous Educational Institution of Higher Education I.M.Sechenov, Moscow, Russia (D.L.)., Turcu AF; Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor (A.F.T., P.V.)., Vibhatavata P; Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor (A.F.T., P.V.)., Fardella CE; Centro Traslacional de Endocrinologia Universidad Catolica de Chile (CETREN-UC), Santiago, Chile (C.E.F., T.U.)., Uslar T; Centro Traslacional de Endocrinologia Universidad Catolica de Chile (CETREN-UC), Santiago, Chile (C.E.F., T.U.)., Quinkler M; Endocrinology in Charlottenburg, Berlin, Germany (M.Q.)., Mulatero P; Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Italy (J.G., J.B., P.M.)., Pintus G; Department of Medicine DIMED, Specialized Center for Blood Pressure Disorders-Regione Veneto, University of Padua, Italy (G.P., G.P.R.)., Rossi GP; Department of Medicine DIMED, Specialized Center for Blood Pressure Disorders-Regione Veneto, University of Padua, Italy (G.P., G.P.R.)., Hahner S; Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Germany (S.H.)., Amar L; Paris City University, Hypertension Unit, Adrenal Referral Center, Paris, France (L.A.)., Drake WM; Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (W.M.D., C.V.)., Varsani C; Department of Endocrinology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (W.M.D., C.V.)., Brown MJ; Endocrine Hypertension, Department of Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Queen Mary University of London, United Kingdom (M.J.B., X.W.)., Wu X; Endocrine Hypertension, Department of Clinical Pharmacology and Precision Medicine, William Harvey Research Institute, Queen Mary University of London, United Kingdom (M.J.B., X.W.)., Young WF Jr; Department of Internal Medicine, Mayo Clinic, Rochester, MN (W.F.Y.)., Williams TA; Department of Medicine IV, LMU University Hospital, Munich, Germany (M.R., C.A., D.B., T.A.W.)., Fuller PJ; Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., R.L., P.J.F.).; Department of Endocrinology, Monash Health, Victoria, Australia (P.J.F.). |
| Πηγή: | Hypertension (Dallas, Tex. : 1979) [Hypertension] 2026 Sep; Vol. 83 (9), pp. e27431. Date of Electronic Publication: 2026 Jul 22. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 7906255 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4563 (Electronic) Linking ISSN: 0194911X NLM ISO Abbreviation: Hypertension Subsets: MEDLINE |
| Imprint Name(s): | Publication: Original Publication: [Dallas, Tex.] : [American Heart Association], [©1979]- |
| Ιατρικοί όροι (MeSH): | Hyperaldosteronism*/drug therapy , Hyperaldosteronism*/complications , Hyperaldosteronism*/blood , Mineralocorticoid Receptor Antagonists*/therapeutic use , Hypertension*/etiology , Hypertension*/drug therapy, Aldosterone/blood ; Humans ; Female ; Male ; Middle Aged ; Treatment Outcome ; Follow-Up Studies ; Time Factors ; Adult |
| Περίληψη: | Background: Primary aldosteronism (PA) is a common and treatable cause of hypertension, yet data on the durability of medical treatment response beyond the first year are limited. Using the PA medical treatment outcomes framework, we evaluated long-term biochemical and clinical outcomes and factors associated with treatment response. Methods: We conducted an international, multicenter, observational cohort study across 27 centers on 4 continents. Adults with PA treated with mineralocorticoid receptor antagonists and/or epithelial sodium channel blockers between 2016 and 2021 were included if follow-up data were available at ≥12 months. Biochemical and clinical responses were classified as complete, partial, or absent using PA medical treatment outcomes criteria. Ordinal logistic regression identified determinants of a favorable treatment response. Results: The cohort included 1292 patients (47.5% women, mean age 52 years) with a median follow-up of 34 months (interquartile range, 21-51). At ≥12 months, 58.3% achieved a complete biochemical response, and 20.8% achieved a complete clinical response, with only 5% showing no response. Determinants of a favorable biochemical response included lower aldosterone and lateralization index, and higher renin and potassium levels at baseline. In those taking spironolactone, a higher daily dose was also associated with a favorable biochemical response. Determinants of a favorable clinical response included female sex, lower body mass index, shorter duration of hypertension, and absence of hypertension-mediated organ damage. Conclusions: Targeted medical therapy for PA can deliver sustained biochemical and clinical benefits. Early disease detection and adequate dose titration are highly actionable determinants of long-term treatment success. |
| Competing Interests: | A.F. Turcu served as advisor for AstraZeneca. P. Mulatero received fees for educational speeches from Diasorin and AstraZeneca. J. Yang served as advisor for AstraZeneca (no consulting fees). The other authors report no conflicts. |
| Contributed Indexing: | Keywords: aldosterone; blood pressure; hyperaldosteronism; mineralocorticoid receptor antagonists; potassium; renin |
| Substance Nomenclature: | 0 (Mineralocorticoid Receptor Antagonists) 4964P6T9RB (Aldosterone) |
| Entry Date(s): | Date Created: 20260722 Date Completed: 20260819 Latest Revision: 20260909 |
| Update Code: | 20260909 |
| DOI: | 10.1161/HYPERTENSIONAHA.126.27431 |
| PMID: | 42483794 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1524-4563 |
|---|---|
| DOI: | 10.1161/HYPERTENSIONAHA.126.27431 |