ReviewEndocrine reviews2024
Biomarkers to Guide Medical Therapy in Primary Aldosteronism.
Review in Endocrine reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Biochemical and renal-metabolic profiles distinguishing primary aldosteronism from essential hypertension: a systematic review and meta-analysis with implications for endocrine hypertension screening.Frontiers in endocrinology · 2026Pooled it
- Major Adverse Cardiovascular Events in Primary Aldosteronism After Adrenalectomy or Mineralocorticoid Receptor Antagonist Treatment: A Systematic Review and Meta-Analysis.Journal of the American Heart Association · 2025Pooled it
- Safety and efficacy of alcohol-mediated bilateral adrenal artery embolization in patients with idiopathic hyperaldosteronism: a 6-month follow-up of a randomized controlled trial.Journal of human hypertension · 2025Trial
- Human biomarker navigator.iMeta · 2026Review
- Bilateral Adrenal Primary Aldosteronism Is Uniformly Present in Hypertensive Afro-Caribbean First-Generation Immigrants to Western Canada.Journal of the American Heart Association · 2026Article
- Low-renin hypertension in incidental adrenal adenomas and response to aldosterone-targeted therapy: a prospective study.European journal of internal medicine · 2026Article
- Primary aldosteronism.Nature reviews. Disease primers · 2026Review
- Endocrine society 2025 diagnostic criteria increase primary aldosteronism detection in hypertensive patients: a comparative study with 2016 guidelines.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Precision biomarker discovery in hypertension through explainable AI and proteomics.Journal of human hypertension · 2026Article
- Renin-to-Aldosterone Ratio Is Associated with Ambulatory Blood Pressure Levels and Control in Treated Hypertensive Patients with Overweight or Obesity.Obesity facts · 2026Article
- Aldosterone fuels the progression of cardiovascular-kidney -metabolic syndrome: focus on primary aldosteronism spectrum.Endocrine · 2026Review
- Is It Time to Retire Aldosterone Suppression Testing?American journal of hypertension · 2026Review
- Optimizing the diagnosis of primary aldosteronism: The role of adrenal vein sampling and the need for high-expertise reference centers.Journal of neuroendocrinology · 2026Observational
- Mineralocorticoid Receptor Antagonist Pre-Adrenalectomy in Primary Aldosteronism.The Journal of clinical endocrinology and metabolism · 2026Article
- Primary aldosteronism and long-term outcomes using PAMO definition.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Article
- Screening and Diagnosis Trends for Primary Aldosteronism: A Longitudinal Nationwide Cohort Study of 7.8 Million People.medRxiv : the preprint server for health sciences · 2025Article
- Re-Considering the Indications for Unilateral Surgical Adrenalectomy in Primary Aldosteronism.Hypertension (Dallas, Tex. : 1979) · 2025Article
- Article
- Nationwide, Pragmatic, Direct-to-Patient Primary Aldosteronism Testing Program.Hypertension (Dallas, Tex. : 1979) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Primary aldosteronism (PA) is an endocrinopathy characterized by dysregulated aldosterone production that occurs despite suppression of renin and angiotensin II, and that is non-suppressible by volume and sodium loading. The effectiveness of surgical adrenalectomy for patients with lateralizing PA is characterized by the attenuation of excess aldosterone production leading to blood pressure reduction, correction of hypokalemia, and increases in renin-biomarkers that collectively indicate a reversal of PA pathophysiology and restoration of normal physiology. Even though the vast majority of patients with PA will ultimately be treated medically rather than surgically, there is a lack of guidance on how to optimize medical therapy and on key metrics of success. Herein, we review the evidence justifying approaches to medical management of PA and biomarkers that reflect endocrine principles of restoring normal physiology. We review the current arsenal of medical therapies, including dietary sodium restriction, steroidal and nonsteroidal mineralocorticoid receptor antagonists, epithelial sodium channel inhibitors, and aldosterone synthase inhibitors. It is crucial that clinicians recognize that multimodal medical treatment for PA can be highly effective at reducing the risk for adverse cardiovascular and kidney outcomes when titrated with intention. The key biomarkers reflective of optimized medical therapy are unsurprisingly similar to the physiologic expectations following surgical adrenalectomy: control of blood pressure with the fewest number of antihypertensive agents, normalization of serum potassium without supplementation, and a rise in renin. Pragmatic approaches to achieve these objectives while mitigating adverse effects are reviewed.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.