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Practical consensus for the treatment and follow-up of primary aldosteronism: a multidisciplinary consensus document

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Abstract

Primary aldosteronism (PA) is the most frequent cause of secondary hypertension and is associated with a higher cardiometabolic risk than essential hypertension. The aim of this consensus is to provide practical clinical recommendations for its surgical and medical treatment, pathology study and biochemical and clinical follow-up, as well as for the approach in special situations like advanced age, pregnancy and chronic kidney disease, from a multidisciplinary perspective, in a nominal group consensus approach of experts from the Spanish Society of Endocrinology and Nutrition (SEEN), Spanish Society of Cardiology (SEC), Spanish Society of Nephrology (SEN), Spanish Society of Internal Medicine (SEMI), Spanish Radiology Society (SERAM), Spanish Society of Vascular and Interventional Radiology (SERVEI), Spanish Society of Laboratory Medicine (SEQC(ML)), Spanish Society of Anatomic-Pathology and Spanish Association of Surgeons (AEC).

Keypoints

  • The treatment of choice for PA is medical therapy with mineralocorticoid receptor blockade for bilateral cases and unilateral adrenalectomy for unilateral PA.

  • The goals of PA treatment are to normalize blood pressure (BP) and excessive aldosterone production, with the final aim of improving associated comorbidities and reducing mortality.

  • Spironolactone is usually the mineralocorticoid receptor antagonist (MRA) of choice for medical treatment of PA. However, eplerenone has a similar efficacy to that of spironolactone when used in doses 2–3 times higher than the latter and administered 2–3 times a day.

  • Eplerenone has the advantage of not inducing the anti-androgenic side effects commonly seen with spironolactone.

  • Adrenalectomy is the gold standard procedure used to remove the aldosterone-hypersecreting adrenal tissue.

  • The Primary Aldosteronism Outcome (PASO) group criteria are recommended for defining the control objectives of biochemical and clinical response to treatment.

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References

  1. J.W. Funder, R.M. Carey, F. Mantero, M.H. Murad, M. Reincke, H. Shibata et al. The management of primary aldosteronism: Case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 101, 1889–1916 (2016). https://doi.org/10.1210/jc.2015-4061

    Article  CAS  PubMed  Google Scholar 

  2. S. Monticone, F. D’Ascenzo, C. Moretti, T.A. Williams, F. Veglio, F. Gaita et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 6, 41–50 (2018). https://doi.org/10.1016/S2213-8587(17)30319-4

    Article  CAS  PubMed  Google Scholar 

  3. P. Mulatero, L.A. Sechi, T.A. Williams, J.W.M. Lenders, M. Reincke, F. Satoh et al. Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. J. Hypertens. 38, 1929–1936 (2020). https://doi.org/10.1097/HJH.0000000000002520

    Article  CAS  PubMed  Google Scholar 

  4. G.L. Hundemer, G.C. Curhan, N. Yozamp, M. Wang, A. Vaidya, Cardiometabolic outcomes and mortality in medically treated primary aldosteronism: a retrospective cohort study. Lancet Diabetes Endocrinol. 6, 51–59 (2018). https://doi.org/10.1016/S2213-8587(17)30367-4

    Article  PubMed  Google Scholar 

  5. G.P. Rossi, V. Bisogni, A.V. Bacca, A. Belfiore, M. Cesari, A. Concistrè et al. The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism. Int. J. Cardiol. Hypertens 5, (2020). https://doi.org/10.1016/j.ijchy.2020.100029.

  6. P. Mulatero, S. Monticone, J. Deinum, L. Amar, A. Prejbisz, M.C. Zennaro et al. Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension. J. Hypertens. 38, 1919–1928 (2020). https://doi.org/10.1097/HJH.0000000000002510

    Article  CAS  PubMed  Google Scholar 

  7. T.A. Williams, C.E. Gomez-Sanchez, W.E. Rainey, T.J. Giordano, A.K. Lam, A. Marker et al. International Histopathology Consensus for Unilateral Primary Aldosteronism. J. Clin. Endocrinol. Metab. 106, 42–54 (2021). https://doi.org/10.1210/clinem/dgaa484

    Article  PubMed  Google Scholar 

  8. M. Scarpelli, F. Algaba, Z. Kirkali, H. Van Poppel, Handling and pathology reporting of adrenal gland specimens. Eur. Urol. 45, 722–729 (2004). https://doi.org/10.1016/J.EURURO.2003.12.006

    Article  CAS  PubMed  Google Scholar 

  9. T.A. Williams, J.W.M. Lenders, P. Mulatero, J. Burrello, M. Rottenkolber, C. Adolf et al. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 5, 689–699 (2017). https://doi.org/10.1016/S2213-8587(17)30135-3

    Article  PubMed  PubMed Central  Google Scholar 

  10. AGREE Collaboration. AGREE Enterprise website n.d. https://www.agreetrust.org/login/?redirect_to=https%3A%2F%2Fwww.agreetrust.org%2Fmy-agree%2F (accessed September 19, 2022)

  11. Screening and diagnosis of Primary Aldosteronism (PA). Consensus document of all the Spanish Societies involved in the management of PA. Endocrine. 2024 [accepted, pending of publication]

  12. M. Araujo-Castro, Treatment of primary hyperaldosteronism. Med Clin. (Barc.) 155, 302–308 (2020). https://doi.org/10.1016/j.medcli.2020.04.029

    Article  PubMed  Google Scholar 

  13. M. Takeda, K. Yamamoto, H. Akasaka, H. Rakugi, M. Naruse, Y. Takeda et al. Clinical characteristics and postoperative outcomes of primary aldosteronism in the elderly. J. Clin. Endocrinol. Metab. 103, 3620–3629 (2018). https://doi.org/10.1210/jc.2018-00059

    Article  PubMed  Google Scholar 

  14. Y. Ohno, M. Naruse, F. Beuschlein, F. Schreiner, M. Parasiliti-Caprino, J. Deinum et al. Adrenal venous sampling-guided adrenalectomy rates in primary aldosteronism: results of an International Cohort (AVSTAT). J. Clin. Endocrinol. Metab. 106, E1400–E1407 (2021). https://doi.org/10.1210/clinem/dgaa706

    Article  PubMed  Google Scholar 

  15. N. Sukor, R.D. Gordon, K.K. Yee, M. Jones, M. Stowasser, Role of unilateral adrenalectomy in bilateral primary aldosteronism: a 22-year single center experience. J. Clin. Endocrinol. Metab. 94, 2437–2445 (2009). https://doi.org/10.1210/JC.2008-2803

    Article  CAS  PubMed  Google Scholar 

  16. T.A. Williams, S. Gong, Y. Tsurutani, Y. Tezuka, M. Thuzar, J. Burrello et al. Adrenal surgery for bilateral primary aldosteronism: an international retrospective cohort study. Lancet Diabetes Endocrinol. 10, 769–771 (2022). https://doi.org/10.1016/S2213-8587(22)00253-4

    Article  PubMed  Google Scholar 

  17. S. Monticone, A. Viola, D. Rossato, F. Veglio, M. Reincke, C. Gomez-Sanchez et al. Adrenal vein sampling in primary aldosteronism: towards a standardised protocol. Lancet Diabetes Endocrinol. 3, 296–303 (2015). https://doi.org/10.1016/S2213-8587(14)70069-5

    Article  CAS  PubMed  Google Scholar 

  18. G.P. Rossi, M. Barisa, B. Allolio, R.J. Auchus, L. Amar, D. Cohen et al. The adrenal vein sampling International study (avis) for identifying the major subtypes of primary aldosteronism. J. Clin. Endocrinol. Metab. 97, 1606–1614 (2012). https://doi.org/10.1210/jc.2011-2830

    Article  CAS  PubMed  Google Scholar 

  19. W.F. Young, Primary aldosteronism: Renaissance of a syndrome. Clin. Endocrinol. (Oxf.) 66, 607–618 (2007). https://doi.org/10.1111/J.1365-2265.2007.02775.X

    Article  CAS  PubMed  Google Scholar 

  20. B. Pitt, F. Zannad, W.J. Remme, R. Cody, A. Castaigne, A. Perez et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N. Engl. J. Med 341, 709–717 (1999). https://doi.org/10.1056/NEJM199909023411001

    Article  CAS  PubMed  Google Scholar 

  21. J.M. Flack, S. Oparil, J.H. Pratt, B. Roniker, S. Garthwaite, J.H. Kleiman et al. Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients. J. Am. Coll. Cardiol. 41, 1148–1155 (2003). https://doi.org/10.1016/S0735-1097(03)00054-8

    Article  CAS  PubMed  Google Scholar 

  22. P.O. Lim, W.F. Young, T.M. MacDonald. A review of the medical treatment of primary aldosteronism. J. Hypertens; 2001. 19. https://doi.org/10.1097/00004872-200103000-00001.

  23. B. Lechner, K. Lechner, D. Heinrich, C. Adolf, F. Holler, H. Schneider et al. Therapy of endocrine disease: medical treatment of primary aldosteronism. Eur. J. Endocrinol. 181, R147–R153 (2019). https://doi.org/10.1530/EJE-19-0215

    Article  CAS  PubMed  Google Scholar 

  24. M. Reincke, I. Bancos, P. Mulatero, U.I. Scholl, M. Stowasser, T.A. Williams, Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol. 9, 876–892 (2021). https://doi.org/10.1016/S2213-8587(21)00210-2

    Article  PubMed  Google Scholar 

  25. O.A. Shariq, K. Mehta, G.B. Thompson, M.L. Lyden, D.R. Farley, I. Bancos et al. Primary aldosteronism: does underlying pathology impact clinical presentation and outcomes following unilateral adrenalectomy? World J. Surg. 43, 2469–2476 (2019). https://doi.org/10.1007/S00268-019-05059-Y

    Article  PubMed  Google Scholar 

  26. C. Mcmanus, J.H. Kuo, Surgical approach to patients with primary aldosteronism. Gland Surg. 9, 25–31 (2020). https://doi.org/10.21037/GS.2019.10.19

    Article  PubMed  PubMed Central  Google Scholar 

  27. M. Iacobone, M. Citton, G. Viel, G.P. Rossi, D. Nitti, Approach to the surgical management of primary aldosteronism. Gland Surg. 4, 69–81 (2015). https://doi.org/10.3978/J.ISSN.2227-684X.2015.01.05

    Article  PubMed  PubMed Central  Google Scholar 

  28. C. Meng, C. Du, L. Peng, J. Li, J. Li, Y. Li, et al. Comparison of posterior retroperitoneoscopic adrenalectomy versus lateral transperitoneal laparoscopic adrenalectomy for adrenal tumors: a systematic review and meta-analysis. Front Oncol 2021;11. https://doi.org/10.3389/FONC.2021.667985

  29. A. Arezzo, A. Bullano, G. Cochetti, R. Cirocchi, J. Randolph, E. Mearini et al. Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults. Cochrane Database Syst Rev 2018;12. https://doi.org/10.1002/14651858.CD011668.PUB2

  30. M. Barczyński, A. Konturek, W. Nowak, Randomized clinical trial of posterior retroperitoneoscopic adrenalectomy versus lateral transperitoneal laparoscopic adrenalectomy with a 5-year follow-up. Ann. Surg. 260, 740–747 (2014). https://doi.org/10.1097/SLA.0000000000000982

    Article  PubMed  Google Scholar 

  31. M. Araujo-Castro, M. Paja Fano, M. González Boillos, B. Pla Peris, E. Pascual-Corrales, A.M. García Cano et al. Evolution of the cardiometabolic profile of primary hyperaldosteronism patients treated with adrenalectomy and with mineralocorticoid receptor antagonists: results from the SPAIN-ALDO Registry. Endocrine 76, 687–696 (2022). https://doi.org/10.1007/s12020-022-03029-4

    Article  CAS  PubMed  Google Scholar 

  32. M. Araujo-Castro, M. Iturregui Guevara, M. Calatayud Gutiérrez, P. Parra Ramírez, P. Gracia Gimeno, F.A. Hanzu et al. Practical guide on the initial evaluation, follow-up, and treatment of adrenal incidentalomas Adrenal Diseases Group of the Spanish Society of Endocrinology and Nutrition. Endocrinol. Diabetes y. Nutr. 67, 408–419 (2020). https://doi.org/10.1016/j.endinu.2020.03.002

    Article  Google Scholar 

  33. L. Kong, J. Zhang, L. Dong, J. Xu, P.J. Gao, J.G. Wang et al. Recurrence of primary aldosteronism 10 years after left adrenalectomy for aldosterone-producing adenoma: a case report. Front Endocrinol (Lausanne) 2021;12. https://doi.org/10.3389/FENDO.2021.728595

  34. M. Citton, G. Viel, G.P. Rossi, F. Mantero, D. Nitti, M. Iacobone, Outcome of surgical treatment of primary aldosteronism. Langenbeck’s Arch. Surg. 400, 325–331 (2015). https://doi.org/10.1007/S00423-014-1269-4

    Article  Google Scholar 

  35. M. Tetti, D. Brüdgam, J. Burrello, A.M. Udager, A.Riester, T. Knösel, et al. Unilateral primary aldosteronism: long-term disease recurrence after adrenalectomy. Hypertens (Dallas, Tex 1979) 2024. https://doi.org/10.1161/HYPERTENSIONAHA.123.22281.

  36. Kpeng Li, X. Duan, Xsong Yang, J. Huang, T. Wu, Partial versus total adrenalectomy for the treatment of unilateral aldosterone-producing adenoma: a systematic review and meta-analysis. Updates Surg. 73, 2301–2313 (2021). https://doi.org/10.1007/S13304-021-01116-1

    Article  PubMed  Google Scholar 

  37. F. Satoh, R. Morimoto, K. Seiji, N. Satani, H. Ota, Y. Iwakura et al. Is there a role for segmental adrenal venous sampling and adrenal sparing surgery in patients with primary aldosteronism? Eur. J. Endocrinol. 173, 465–477 (2015). https://doi.org/10.1530/EJE-14-1161

    Article  CAS  PubMed  Google Scholar 

  38. R.Q. Guo, Y.M. Li, X.G. Li, Comparison of the radiofrequency ablation versus laparoscopic adrenalectomy for aldosterone-producing adenoma: a meta-analysis of perioperative outcomes and safety. Updates Surg. 73, 1477–1485 (2021). https://doi.org/10.1007/S13304-021-01069-5

    Article  PubMed  Google Scholar 

  39. O. Cano-Valderrama, J. González-Nieto, M. Abad-Cardiel, S. Ochagavía, I. Rünkle, J.V. Méndez et al. Laparoscopic adrenalectomy vs. radiofrequency ablation for the treatment of primary aldosteronism. A single center retrospective cohort analysis adjusted with propensity score. Surg. Endosc. 36, 1970–1978 (2022). https://doi.org/10.1007/S00464-021-08481-3

    Article  PubMed  Google Scholar 

  40. A. Hodgson, S. Pakbaz, O. Mete, A diagnostic approach to adrenocortical tumors. Surg. Pathol. Clin. 12, 967–995 (2019). https://doi.org/10.1016/J.PATH.2019.08.005

    Article  PubMed  Google Scholar 

  41. Carcinomas Of The Adrenal Cortex Structured Reporting Protocol (1st Edition 2020) 2020.

  42. O. Mete, L.A. Erickson, C.C. Juhlin, R.R. de Krijger, H. Sasano, M. Volante et al. Overview of the 2022 WHO classification of adrenal cortical tumors. Endocr. Pathol. 33, 155–196 (2022). https://doi.org/10.1007/S12022-022-09710-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. C.C. Juhlin, J. Bertherat, T.J. Giordano, G.D. Hammer, H. Sasano, O. Mete, What did we learn from the molecular biology of adrenal cortical neoplasia? from histopathology to translational genomics. Endocr. Pathol. 32, 102–133 (2021). https://doi.org/10.1007/S12022-021-09667-0

    Article  CAS  PubMed  Google Scholar 

  44. O. Steichen, L. Amar, P. Chaffanjon, J.L. Kraimps, F. Ménégaux, F. Zinzindohoue, SFE/SFHTA/AFCE consensus on primary aldosteronism, part 6: Adrenal surgery. Ann. Endocrinol. (Paris) 77, 220–225 (2016). https://doi.org/10.1016/J.ANDO.2016.01.009

    Article  PubMed  Google Scholar 

  45. J.W. Funder, R.M. Carey, C. Fardella, C.E. Gomez-Sanchez, F. Mantero, M. Stowasser et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 93, 3266–3281 (2008). https://doi.org/10.1210/jc.2008-0104

    Article  CAS  PubMed  Google Scholar 

  46. E. Fischer, G. Hanslik, A. Pallauf, C. Degenhart, U. Linsenmaier, F. Beuschlein et al. Prolonged zona glomerulosa insufficiency causing hyperkalemia in primary aldosteronism after adrenalectomy. J. Clin. Endocrinol. Metab. 97, 3965–3973 (2012). https://doi.org/10.1210/jc.2012-2234

    Article  CAS  PubMed  Google Scholar 

  47. F.T. Lee, D. Elaraj, Evaluation and management of primary hyperaldosteronism. Surg. Clin. North Am. 99, 731–745 (2019). https://doi.org/10.1016/J.SUC.2019.04.010

    Article  PubMed  Google Scholar 

  48. A.N.D. Cat, M. Friederich-Persson, A. White, R.M. Touyz, Adipocytes, aldosterone and obesity-related hypertension. J. Mol. Endocrinol. 57, F7–F21 (2016). https://doi.org/10.1530/JME-16-0025

    Article  CAS  Google Scholar 

  49. N. Wada, Y. Shibayama, H. Umakoshi, T. Ichijo, Y. Fujii, K. Kamemura et al. Hyperkalemia in both surgically and medically treated patients with primary aldosteronism. J. Hum. Hypertens. 31, 627–632 (2017). https://doi.org/10.1038/JHH.2017.38

    Article  CAS  PubMed  Google Scholar 

  50. A. Spyroglou, L. Handgriff, L. Müller, P. Schwarzlmüller, M. Parasiliti-Caprino, C.T. Fuss et al. The metabolic phenotype of patients with primary aldosteronism: impact of subtype and sex - a multicenter-study of 3566 Caucasian and Asian subjects. Eur. J. Endocrinol. 187, 361–372 (2022). https://doi.org/10.1530/EJE-22-0040

    Article  CAS  PubMed  Google Scholar 

  51. B. Williams, G. Mancia, W. Spiering, E. Agabiti Rosei, M. Azizi, M. Burnier et al. 2018 ESC/ESH Guidelines for the management of arterial hypertensionThe Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur. Heart J. 39, 3021–3104 (2018). https://doi.org/10.1093/EURHEARTJ/EHY339

    Article  PubMed  Google Scholar 

  52. M. Proietti, M. Cesari, Frailty: What Is It? Adv. Exp. Med Biol. 1216, 1–7 (2020). https://doi.org/10.1007/978-3-030-33330-0_1

    Article  PubMed  Google Scholar 

  53. J.M. Brown, P.C. Underwood, C. Ferri, P.N. Hopkins, G.H. Williams, G.K. Adler et al. Aldosterone dysregulation with aging predicts renal vascular function and cardiovascular risk. Hypertens. (Dallas, Tex. 1979) 63, 1205–1211 (2014). https://doi.org/10.1161/HYPERTENSIONAHA.114.03231

    Article  CAS  Google Scholar 

  54. P. Mulatero, J. Burrello, T.A. Williams, S. Monticone. Primary aldosteronism in the elderly. J. Clin. Endocrinol. Metab. 2020;105. https://doi.org/10.1210/CLINEM/DGAA206.

  55. K. Nishimoto, K. Nakagawa, D. Li, T. Kosaka, M. Oya, S. Mikami et al. Adrenocortical zonation in humans under normal and pathological conditions. J. Clin. Endocrinol. Metab. 95, 2296–2305 (2010). https://doi.org/10.1210/JC.2009-2010

    Article  CAS  PubMed  Google Scholar 

  56. K. Nanba, A. Vaidya, W.E. Rainey, Aging and adrenal aldosterone production. Hypertens. (Dallas, Tex. 1979) 71, 218–223 (2018). https://doi.org/10.1161/HYPERTENSIONAHA.117.10391

    Article  CAS  Google Scholar 

  57. C. Nakama, K. Kamide, T. Kawai, K. Hongyo, N. Ito, M. Onishi et al. The influence of aging on the diagnosis of primary aldosteronism. Hypertens. Res 37, 1062–1067 (2014). https://doi.org/10.1038/hr.2014.129

    Article  CAS  PubMed  Google Scholar 

  58. L. Zhu, Y. Zhang, H. Zhang, W. Zhou, Z. Shen, F. Zheng et al. Comparison between adrenal venous sampling and computed tomography in the diagnosis of primary aldosteronism and in the guidance of adrenalectomy. Med. (Baltim.) 95, 1–6 (2016). https://doi.org/10.1097/MD.0000000000004986

    Article  Google Scholar 

  59. P. Parra Ramírez, P.M. Rojas-Marcos, M. Paja Fano, M. González Boillos, E. Pascual-Corrales, A. García-Cano, et al. Differences in the presentation and evolution of primary aldosteronism in elderly (≥65 years) and young patients). Endocr. Connect 2022;11. https://doi.org/10.1530/EC-22-0169

  60. V. Forestiero, E. Sconfienza, P. Mulatero, S. Monticone, Primary aldosteronism in pregnancy. Rev. Endocr. Metab. Disord. 24, 39–48 (2023). https://doi.org/10.1007/S11154-022-09729-6

    Article  CAS  PubMed  Google Scholar 

  61. S. Monticone, R.J. Auchus, W.E. Rainey, Adrenal disorders in pregnancy. Nat. Rev. Endocrinol. 8, 668–678 (2012). https://doi.org/10.1038/NRENDO.2012.155

    Article  CAS  PubMed  Google Scholar 

  62. L. Malha, P. August. Secondary hypertension in pregnancy. Curr. Hypertens Rep. 2015;17. https://doi.org/10.1007/S11906-015-0563-Z.

  63. A. Riester, M. Reincke, Progress in primary aldosteronism: mineralocorticoid receptor antagonists and management of primary aldosteronism in pregnancy. Eur. J. Endocrinol. 172, R23–R30 (2015). https://doi.org/10.1530/EJE-14-0444

    Article  CAS  PubMed  Google Scholar 

  64. E. Landau, L. Amar, Primary aldosteronism and pregnancy. Ann. Endocrinol. (Paris) 77, 148–160 (2016). https://doi.org/10.1016/j.ando.2016.04.009

    Article  PubMed  Google Scholar 

  65. V. Sanga, G. Rossitto, T.M. Seccia, G.P. Rossi, Management and outcomes of primary aldosteronism in pregnancy: a systematic review. Hypertens. (Dallas, Tex. 1979) 79, 1912–1921 (2022). https://doi.org/10.1161/HYPERTENSIONAHA.121.18858

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Alberto Fernandez for the review of the manuscript. This consensus was sponsored by all implicated Societies.

Funding

This research was funded by all implicated societies.

Author information

Authors and Affiliations

  1. Endocrinology & Nutrition Department. Hospital Universitario Ramón y Cajal. Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), University of Alcalá, Madrid, Spain

    Marta Araujo-Castro

  2. Endocrinology & Nutrition Department. Hospital Universitario Fundación Jiménez Díaz, Health Research Institute-Fundación Jiménez Díaz University Hospital (IIS-FJD, UAM), Madrid, Spain

    Jorge Gabriel Ruiz-Sánchez

  3. Endocrinology & Nutrition Department, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain

    Paola Parra Ramírez & Patricia Martín Rojas-Marcos

  4. Cardiology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain

    Almudena Aguilera-Saborido

  5. Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain

    Jorge Francisco Gómez Cerezo

  6. Biochemical Department, Hospital Universitario Gregorio Marañón, Madrid, Spain

    Nieves López Lazareno

  7. Biochemical Department, Hospital General Universitario Dr. Balmis de Alicante, Alicante, Spain

    María Eugenia Torregrosa

  8. Biochemical department, Laboratori de Referència de Catalunya, Barcelona, Spain

    Jorge Gorrín Ramos

  9. Biochemistry and Molecular Genetics Department. CDB. Hospital Clínic, University of Barcelona, Barcelona, Spain

    Josep Oriola

  10. Nephrology Department. Hospital Clinic. IDIBAPS, University of Barcelona, Barcelona, Spain

    Esteban Poch

  11. Nephrology Department, Hospital del Mar Universitat Pompeu Fabra, Barcelona, Spain

    Anna Oliveras

  12. Vascular and Interventional Radiology Department, Hospital Clínico San Carlos, Madrid, Spain

    José Vicente Méndez Monter

  13. Radiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Isabel Gómez Muriel

  14. Pathology Department, Parc Taulí Hospital Universitari. Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA). Universitat Autònoma de Barcelona. Sabadell. ES, Barcelona, Spain

    María Rosa Bella-Cueto

  15. General Surgery. Hospital General Universitario Gregorio Marañón, Fellow European Board of Surgery -Endocrine Surgery, Madrid, Spain

    Enrique Mercader Cidoncha

  16. Endocrinology and Nutrition Department, Hospital Clinico San Carlos Madrid, Madrid, Spain

    Isabelle Runkle

  17. Endocrinology & Nutrition Department. Hospital Clinic. IDIBAPS, University of Barcelona, Barcelona, Spain

    Felicia A. Hanzu

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  1. Marta Araujo-Castro
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Contributions

"MAC and FH wrote the main manuscript text and all authors reviewed the manuscript."

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Correspondence to Marta Araujo-Castro or Felicia A. Hanzu.

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In representation of the following medical Spanish societies: Spanish Society of Endocrinology and Nutrition (SEEN), Spanish Society of Cardiology (SEC), Spanish Society of Nephrology (SEN), Spanish Society of Internal Medicine (SEMI), Spanish Radiology Society (SERAM), Spanish Society of Vascular and Interventional Radiology (SERVEI), Spanish Society of Laboratory Medicine (SEQC(ML), Spanish Society of Anatomic-Pathology (SEAP), Spanish Association of Surgeons (AEC).

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Araujo-Castro, M., Ruiz-Sánchez, J.G., Ramírez, P.P. et al. Practical consensus for the treatment and follow-up of primary aldosteronism: a multidisciplinary consensus document. Endocrine (2024). https://doi.org/10.1007/s12020-024-03773-9

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