Medical management of aldosterone-producing adenomas

Background: No data are available on the long-term medical management of al dosterone-producing adenomas. Objective: To demonstrate the efficacy of medical management of aldosterone -producing adenomas in terms of blood pressure and serum potassium concentr ation and to discuss morbidity associated with medical management. Design: Retrospective cohort study. Setting: Large tertiary care referral c enter. Patients: 24 patients with documented aldosterone-producing adenomas who we re treated medically for at least 5 years. Measurements: Aldosterone excretion rate, plasma renin activity, and size a nd location of adenomas (by computed tomography). Blood pressure and serum electrolytes were measured at the time of diagnosis and last follow-up. Results: From the time of diagnosis to the time of last follow-up, systolic blood pressure decreased from 175 mm Hg to 129 mm Hg (95% CI for differenc e, 37.1 to 53.8 mm Hg) and diastolic blood pressure decreased from 106 mm H g to 79 mm Hg (CI for difference, 20.8 to 33.9 mm Hg). Serum potassium conc entration increased from 3.0 mmol/L to 4.3 mmol/L (CI for difference, 1.1 t o 1.5 mmol/L). Conclusions: Medical management of aldosterone-producing adenomas is a viab le option for controlling blood pressure and serum potassium concentration.