The treatment of primary hyperaldosteronism

The present review deals with the treatment of main nosological forms of primary hyperaldosteronism, such as aldosteron-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). Much attention is given to perioperative management of APA patients for whom surgical treatment is the method of choice. Idiopathic hyperaldosteronism characterized by bilateral macro- and micronodular changes dictates the necessity of medicamentous therapy, in the first place with antagonists of mineralocorticoid receptors (e.g. spironolactone). Pharmacological standards of drug therapy are described for patients with IHA and those with APA in whom surgical treatment is impracticable.