RICHARD F. SPARK, M.D.; JAMES C. MELBY, M.D.
Hyperaldosteronism causes the hypertension and metabolic abnormalities characteristic of primary aldosteronism. Hyperaldosteronism does not cause the hypertension of patients with secondary aldosteronism but may be responsible for certain electrolyte abnormalities generally associated with aldosterone excess. In view of this, elimination of excess aldosterone either by adrenalectomy or as reported here by pharmacologic blockade with high dose (400 mg/day), long-term (3 to 5 weeks) spironolactone corrects both the hypertension and metabolic abnormalities of primary aldosteronism but only reverses the metabolic abnormalities and does not relieve the hypertension of secondary aldosteronism. Thus, preoperative treatment with high-dose, long-term spironolactone therapy accurately predicts the response that might be expected after adrenal surgery.
SPARK RF, MELBY JC. Aldosteronism in Hypertension: The Spironolactone Response Test. Ann Intern Med. ;69:685–691. doi: 10.7326/0003-4819-69-4-685
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Published: Ann Intern Med. 1968;69(4):685-691.
Adrenal Disorders, Cardiology, Coronary Risk Factors, Endocrine and Metabolism, Hypertension.
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