Advances in Medical Treatment of Primary Aldosteronism

Ying-Jie Li; Zhi-Gang Ji; Jin Wen

doi:10.24920/004137

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Advances in Medical Treatment of Primary Aldosteronism

Chinese Medical Sciences Journal Vol. 38, Issue 1, Pages: 49-56(2023)

Review | Updated：2024-03-30

- Advances in Medical Treatment of Primary Aldosteronism
- Affiliations：
  
  Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  *Jin Wen, wjpumch@163.com.
- Funds：
- DOI：10.24920/004137
  CLC：
- Received：01 July 2022，
  
  Accepted：2022-9-23，
  
  Published Online：16 January 2023，
  
  Published：31 March 2023
- Accepted：
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Ying-Jie Li, Zhi-Gang Ji, Jin Wen. Advances in Medical Treatment of Primary Aldosteronism[J]. Chinese medical sciences journal, 2023, 38(1): 49-56.
DOI：

Ying-Jie Li, Zhi-Gang Ji, Jin Wen. Advances in Medical Treatment of Primary Aldosteronism[J]. Chinese medical sciences journal, 2023, 38(1): 49-56. DOI： 10.24920/004137.

摘要

原发性醛固酮增多症（primary aldosteronism，PA）是继发性高血压最常见的形式，主要表现为高血压和低钾血症。原发性醛固酮增多症的早期识别是非常重要的，因为原发性醛固酮增多症患者发生心血管并发症的可能性更高，如房颤、卒中和心肌梗死。在过去的十年中，原发性醛固酮增多症的遗传学研究取得了惊人的进展，为其治疗提供了新的指导。单侧病变首选手术治疗，双侧病变可用盐皮质激素受体拮抗剂（mineralocorticoid receptor antagonist，MRA）治疗。新一代非甾体MRA正在研究中。新的药物治疗策略包括钙通道阻滞剂、大环内酯类抗生素、醛固酮合成酶抑制剂，为原发性醛固酮增多症的治疗提供了新的视角。

Abstract

Primary aldosteronism (PA) is the most common form of secondary hypertension

with its main manifestations including hypertension and hypokalemia. Early identification of PA is extremely important as PA patients can easily develop cardiovascular complications such as atrial fibrillation

stroke

and myocardial infarction. The past decade has witnessed the rapid advances in the genetics of PA

which has shed new light on PA treatment. While surgery is the first choice for unilateral diseases

bilateral lesions can be treated with mineralocorticoid receptor antagonists (MRAs). The next-generation non-steroidal MRAs are under investigations. New medications including calcium channel blockers

macrophage antibiotics

and aldosterone synthase inhibitors have provided a new perspective for the medical treatment of PA.

关键词

Keywords

references

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