{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:40:27Z","timestamp":1780929627606,"version":"3.54.1"},"reference-count":148,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>The syndrome of primary aldosteronism (PA) is characterized by hypertension with excessive, autonomous aldosterone production and is usually caused by either a unilateral aldosterone-producing adenoma or bilateral adrenal hyperplasia. The diagnostic workup of PA is a sequence of three phases comprising screening tests, confirmatory tests and the differentiation of unilateral from bilateral forms. The latter step is necessary to determine the optimal treatment approach of unilateral laparoscopic adrenalectomy (for patients with unilateral PA) or medical treatment with a mineralocorticoid receptor antagonist (for patients with bilateral PA). Since the publication of the revised Endocrine Society guideline 2016, a number of key studies have been published. They challenge the recommendations of the guideline in some areas and confirm current practice in others. Herein, we present the recent developments and current approaches to the medical management of PA.<\/jats:p>","DOI":"10.1530\/eje-17-0990","type":"journal-article","created":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T16:10:55Z","timestamp":1524154255000},"page":"R19-R29","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":108,"title":["MANAGEMENT OF ENDOCRINE DISEASE: Diagnosis and management of primary aldosteronism: the Endocrine Society guideline 2016 revisited"],"prefix":"10.1093","volume":"179","author":[{"given":"Tracy Ann","family":"Williams","sequence":"first","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Munich, Germany"},{"name":"2Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"1Medizinische Klinik und Poliklinik IV, Klinikum der Universit\u00e4t, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"ref1061","doi-asserted-by":"crossref","first-page":"329","DOI":"10.7326\/0003-4819-151-5-200909010-00007","article-title":"Systematic review: diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism","volume":"151","year":"2009","journal-title":"Annals of Internal Medicine"},{"key":"ref441","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1111\/cen.13110","article-title":"Does ACTH improve the diagnostic performance of adrenal vein sampling for subtyping primary aldosteronism?","volume":"85","year":"2016","journal-title":"Clinical Endocrinology"},{"key":"ref691","doi-asserted-by":"crossref","first-page":"e06315","DOI":"10.7554\/eLife.06315","article-title":"Recurrent gain of function mutation in calcium channel CACNA1H causes early-onset hypertension with primary aldosteronism","volume":"4","year":"2015","journal-title":"Elife"},{"key":"ref941","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11154-011-9163-7","article-title":"Commentary on the Endocrine Society Practice Guidelines: consequences of adjustment of antihypertensive medication in screening of primary aldosteronism","volume":"12","year":"2011","journal-title":"Reviews in Endocrine and Metabolic Disorders"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/HJH.0000000000000762","article-title":"Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium: systematic review and meta-analyses","volume":"34","year":"2016","journal-title":"Journal of Hypertension"},{"key":"ref1401","doi-asserted-by":"crossref","first-page":"3117","DOI":"10.1210\/jc.2008-0594","article-title":"A novel form of human mendelian hypertension featuring nonglucocorticoid-remediable aldosteronism","volume":"93","year":"2008","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1210\/jc.2012-3934","article-title":"Aldosterone excess impairs first phase insulin secretion in primary aldosteronism.","volume":"98","year":"2013","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0889-8529(18)30425-0","article-title":"Primary aldosteronism. 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