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Targeted treatment of primary aldosteronism – The consensus of Taiwan Society of Aldosteronism

2018; Elsevier BV; Volume: 118; Issue: 1 Linguagem: Inglês

10.1016/j.jfma.2018.01.006

1876-0821

Kuo‐How Huang, Chih‐Chin Yu, Ya‐Hui Hu, Chin‐Chen Chang, Chieh‐Kai Chan, Shih‐Cheng Liao, Yao‐Chou Tsai, Shih‐Chieh Chueh, Vin‐Cent Wu, Yen‐Hung Lin, Vin‐Cent Wu, Jui‐Hsiang Lin, Shuo‐Meng Wang, Che‐Hsiung Wu, Ya‐Hui Hu, Leay Kiaw Er, Chia‐Hui Chang, Yali Chang, Yao‐Chou Tsai, Chih‐Chin Yu, Yen‐Hung Lin, Yi‐Lwun Ho, Hung‐Wei Chang, Lian‐Yu Lin, Fu–Chang Hu, Chin‐Chen Chang, Kao‐Lang Liu, Shuo‐Meng Wang, Kuo‐How Huang, Shih‐Chieh Chueh, Shih‐Cheng Liao, Ching‐Chu Lu, Ruoh‐Fang Yen, Kwan‐Dun Wu,

Adrenal Hormones and Disorders

Even with the increasing recognition of primary aldosteronism (PA) as a cause of refractory hypertension and an issue of public health, the consensus of its optimal surgical or medical treatment in Taiwan has not been reached. Our objective was to develop a clinical practice guideline that is feasible for real-world management of PA patients in Taiwan. The Taiwan Society of Aldosteronism (TSA) Task Force recognized the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics and constraints into PA management. In patients with lateralized PA, including aldosterone producing adenoma (APA), laparoscopic adrenalectomy is the ‘gold standard’ of treatment. Mini-laparoscopic and laparoendoscopic single-site approaches are feasible only in highly experienced surgeons. Patients with bilateral adrenal hyperplasia or those not suitable for surgery should be treated by mineralocorticoid receptor antagonists. The outcome data of PA patient management from the literature, especially from PA patients in Taiwan, are reviewed. Mental health screening is helpful in early detection and management of psychopathology among PA patients. We hope this consensus will provide a guideline to help medical professionals to manage PA patients in Taiwan to achieve a better quality of care.