Primary aldosteronism

Excess aldosterone production by the adrenal glands independent of the renin-angiotensin system. A common cause of secondary and resistant hypertension. Detected in 5–10% of patients with arterial hypertension.

ICD-10 E26.01 drug

Also known as: Conn syndrome, Primary hyperaldosteronism

Drugs used for this condition

ASpironolactoneFirst line · Potassium-sparing diuretics (mineralocorticoid receptor antagonists)Spironolactone is the drug of choice for primary aldosteronism when surgery is not feasible or the patient declines operation. Doses are typically higher than in HF – 100–400 mg daily. In bilateral adrenal hyperplasia, medical therapy with spironolactone is the primary treatment.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit