Medical Management of Aldosterone-Producing Adenomas

BACKGROUND: No data are available on the long-term medical management of aldosterone-producing adenomas. OBJECTIVE: To demonstrate the efficacy of medical management of aldosterone-producing adenomas in terms of blood pressure and serum potassium concentration and to discuss morbidity associated with medical management. DESIGN: Retrospective cohort study. SETTING: Large tertiary care referral center. PATIENTS: 24 patients with documented aldosterone-producing adenomas who were treated medically for at least 5 years. MEASUREMENTS: Aldosterone excretion rate, plasma renin activity, and size and location of adenomas (by computed tomography). Blood pressure and serum electrolytes were measured at the time of diagnosis and last follow-up. RESULTS: From the time of diagnosis to the time of last follow-up, systolic blood pressure decreased from 175 mm Hg to 129 mm Hg (95% CI for difference, 37.1 to 53.8 mm Hg) and diastolic blood pressure decreased from 106 mm Hg to 79 mm Hg (CI for difference, 20.8 to 33.9 mm Hg). Serum potassium concentration increased from 3.0 mmol/L to 4.3 mmol/L (CI for difference, 1.1 to 1.5 mmol/L). CONCLUSIONS: Medical management of aldosterone-producing adenomas is a viable option for controlling blood pressure and serum potassium concentration.