41
st Annual Meeting of September 5-6, 2020 the Endocrine Society and the Diabetes Association of the R.O.C. (Taiwan)
The
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THE LONG TERM OUTCOME OF PRIMARY ALDOSTERONISM VIN-CENT WU Department of internal medicine, National Taiwan University Hospital, Taiwan
Although the role of primary aldosteronism (PA) in increasing cardiovascular risk and the potential of targeted therapy for PA have gained recognition, there exists a great knowledge gap in terms of long-term effects of various surgical and pharmacological treatments on outcomes among PA patients. For instance, it remains unclear whether certain targeted treatments for PA can yield everlasting elimination of high blood pressure and regression of the adverse cardiovascular changes. However, patients with IHA may have a different genotype and phenotype compared to APA, the clinical decision of targeted treatments for APA and long term outcome retained unmet study. Previous studies showed impaired glucose homeostasis and insulin resistance (IR) in PA patients, leading to increased prevalence of metabolic syndrome (MS), which could be improved after adrenalectomy. A cohort study reported a higher risk of cardiometabolic events and death in all PA patients than in essential hypertension counterparts in the follow–up after treatment with a mineralocorticoid receptor antagonist (MRA). In a cohort of PA patients with or without adrenal adenoma, surgical or medical treatment has a compatible cardiovascular outcome in the long term. While we had showed adrenalectomy could decreases long-term all-cause mortality independently from cure from hypertension in all PA patients from a claims database, whether MRA treatment produce a similar effect as adrenalectomy in terms of prevention of cardiovascular events or mortality among APA is unclear.
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