What question did this study set out to answer?

To evaluate the impact of discontinuing mineralocorticoid receptor antagonists on the effectiveness of adrenal venous sampling and patient outcomes.

April 12, 2026

Mineralocorticoid Receptor Antagonist Discontinuation in Adrenal Venous Sampling for Subtyping Patients With Primary Hyperaldosteronism: A Systematic Review and Meta‐Analysis

Key Points

To evaluate the impact of discontinuing mineralocorticoid receptor antagonists on the effectiveness of adrenal venous sampling and patient outcomes.
Conducted a systematic review and meta-analysis of existing studies
Assessed diagnostic performance of adrenal venous sampling with and without MRA discontinuation
Analyzed postoperative outcomes and rates of primary aldosteronism lateralization
No significant negative effects on the diagnostic performance of adrenal venous sampling with concurrent MRA use
Lateralization rates for primary aldosteronism were unaffected by MRA discontinuation
Postoperative outcomes were comparable regardless of MRA treatment status

Abstract

Concurrent use of MRA treatment did not adversely affect the diagnostic performance of AVS, rates of PA lateralization or postoperative outcomes. These results suggest that discontinuation of MRAs, despite being recommended by society guidelines, may not be necessary, and instead support a patient-centred approach to management of PA. Given the overall low quality of evidence, future prospective studies are needed to address this dilemma.

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Mineralocorticoid Receptor Antagonist Discontinuation in Adrenal Venous Sampling for Subtyping Patients With Primary Hyperaldosteronism: A Systematic Review and Meta‐Analysis

Key Points

Abstract

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