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Inicio Endocrinología, Diabetes y Nutrición (English ed.) Executive summary of the Spanish consensus for the diagnosis, management, and fo...
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Vol. 71. Issue 8.
Pages 355-364 (October 2024)
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Vol. 71. Issue 8.
Pages 355-364 (October 2024)
Consensus document
Executive summary of the Spanish consensus for the diagnosis, management, and follow-up of primary hyperaldosteronism
Resumen ejecutivo del consenso español para el diagnóstico, el tratamiento y el seguimiento del hiperaldosteronismo primario
Marta Araujo-Castroa,
Corresponding author
marta.araujo@salud.madrid.org

Corresponding authors.
, Paola Parra Ramírezb, Felicia A. Hanzuc,
Corresponding author
fhanzu@clinic.cat

Corresponding authors.
, On behalf the following medical Spanish societies: SEEN, SEC, SEN, SEMI, SERAM, SERVEI, SEQC(ML), AEC 1
a Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
b Endocrinology & Nutrition Department, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
c Endocrinology & Nutrition Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
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Tables (7)
Table 1. Indications for PH screening and prevalence in these settings.
Table 2. Criteria of biochemical screening for primary hyperaldosteronism.
Table 3. Conditions and drugs affecting PAC, renin, and ARR.
Table 4. Dynamic test for PH confirmation.
Table 5. Parameters to calculate in the adrenal venous sampling for PH subtyping.42
Table 6. Medical treatment of PH.28
Table 7. Definition of surgical outcomes in PH.14
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Abstract

Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension (HTN) and is associated with a higher cardiometabolic risk than essential HTN. Nevertheless, PH remains clearly underdiagnosed. An early diagnosis and adequate treatment of this disease are essential to reduce the cardiometabolic morbimortality associated with aldosterone excess. PH follow-up is equally essential; however, there is little consensus on how it should be performed, being a topic rarely mentioned by the different clinical practice guidelines. The aim of this executive summary is to summarize the recommendations made in the Spanish consensus of PH for the diagnosis, management, and follow-up of these patients. The Spanish consensus was reached from a multidisciplinary perspective through a nominal group consensus approach by experts from the Spanish Society of Endocrinology and Nutrition (SEEN), the Spanish Society of Cardiology (SEC), the Spanish Society of Nephrology (SEN), the Spanish Society of Internal Medicine (SEMI), the Spanish Society of Radiology (SERAM), the Spanish Society of Vascular and Interventional Radiology (SERVEI), the Spanish Society of Laboratory Medicine (SEQC(ML)), the Spanish Society of Anatomic-Pathology (EAP), and the Spanish Association of Surgeons (AEC).

Keywords:
Primary hyperaldosteronism
Aldosterone-to-renin ratio
Adrenalectomy
Hypertension
Spironolactone
Eplerenone
Resumen

El hiperaldosteronismo primario (HAP) es la causa más frecuente de hipertensión arterial (HTA) secundaria, y se asocia con un mayor riesgo cardio metabólico que la HTA esencial. Sin embargo, el HAP todavía se encuentra claramente infradiagnosticado. Un diagnóstico precoz y un tratamiento adecuado de esta enfermedad son fundamentales para reducir la morbimortalidad cardiometabólica asociada al exceso de aldosterona. El seguimiento del HAP también es un punto importante, sin embargo, existe poco consenso sobre cómo se debe realizar, siendo un tema apenas mencionado en las diferentes guías clínicas. El objetivo de este resumen ejecutivo es resumir las recomendaciones aportadas en el consenso español de HAP en relación con el diagnóstico, el tratamiento y el seguimiento de estos pacientes. El consenso español se elaboró desde una perspectiva multidisciplinar, en un enfoque de consenso de grupo nominal por expertos de la Sociedad Española de Endocrinología y Nutrición (SEEN), de la Sociedad Española de Cardiología (SEC), de la Sociedad Española de Nefrología (SEN), de la Sociedad Española de Medicina Interna (SEMI), de la Sociedad Española de Radiología (SERAM), de la Sociedad Española de Radiología Vascular e Intervencionista (SERVEI), de la Sociedad Española de Medicina de Laboratorio (SEQC(ML), de la Sociedad Española de Anatomía Patológica (EAP) y de la Asociación Española de Cirujanos (AEC).

Palabras clave:
Hiperaldosteronismo primario
Cociente aldosterona/renina
Adrenalectomía
Hipertensión
Espironolactona
Eplerenona

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