text stringlengths 16 2.35k | tokenCount int64 5 450 | pageStart int64 1 43 | pageEnd int64 1 43 | hash stringlengths 64 64 |
|---|---|---|---|---|
Broader implementation will depend on embedding PA screening within existing hypertension management frameworks, supported by education for clini - cians and individuals, and ongoing monitoring to ensure ben - efits reach all populations equitably. | 43 | 32 | 32 | a1b4d427a75800c515ecba88cd1fb7a2b5f1b57da0239c8762a8e0a6758fb3f2 |
To support the adoption of this recommendation and address challenges in implemen - tation, the guideline offers PA screening and management al - gorithms as practical tools ( Figs. 1 - 3 ). | 41 | 32 | 32 | 360aceb022a1fa592bb2f33529383e025b91949f68980f40127b4a21c2bfaeda |
Medical Therapy With Epithelial Sodium-Channel Inhibitors vs Mineralocorticoid Receptor Antagonists (Steroidal and Nonsteroidal) for Individuals With Primary Aldosteronism Background With increased screening and diagnosis of primary aldosteronism (PA), the need for medical treatment will continue to grow ( 209 ). | 67 | 32 | 32 | 0fdd6623b65f4e7a76016bd55a08d4552a71c42fd0bc9f5384e0f036ca379ff1 |
The most commonly used and targeted medical treatments are mineralocorticoid receptor antagonists (MRAs), which are gener - ally widely available and inexpensive. For individuals who cannot tolerate MRAs (eg, due to effects on androgen or progesterone re - ceptors), a lower-cost, second-line option such as epithelial s... | 83 | 32 | 32 | 57a121665a0e60f31fc4fdab7e345af8de4dd35e981a5f341252175f6ae4a324 |
PA is often associated with resistant or refractory hypertension ( 219 ). The significance of aldosterone in resistant hypertension is supported by studies demonstrating that aldosterone synthase inhibitors reduce blood pressure (BP) in treatment-resistant hypertension ( 220 ). | 49 | 32 | 32 | acaa57eb7eafda6b05f5d3bec5f8a982de4dcd7b43b60fefd89a58010e9a05ae |
In PA, renal sodium reabsorption is increased, leading to vol - ume expansion and higher BP. The increased sodium reabsorp - tion is due to aldosterone-mediated activation of renal mineralocorticoid receptors (MRs) and consequent increased ex - pression and activation of the renal ENaCs ( 221 ). | 70 | 32 | 32 | dc42b82c76482445c55751c0f119546241549a55b15c4ec854524f8eeacb5604 |
Increased ENaC activity leads to increased sodium reabsorption and potas - sium excretion in the distal convoluted nephron. ENaC is a major regulator of sodium excretion during feedback regulation of BP by the renin – angiotensin – aldosterone system (RAAS) ( 221 , 222 ). | 68 | 32 | 32 | e316438ad1f3cf98ca45ceec2b489205f707459793e95c2c8c7c494cf0353f6b |
End-organ damage in individuals with PA is more severe than in individuals with primary hypertension, and includes left ven - tricular hypertrophy, cardiac fibrosis, arterial stiffness, tubuloin - terstitial fibrosis, microalbuminuria, and microvascular damage ( 2 , 223 , 224 ). | 63 | 32 | 32 | 7e1fff44392b5e30474e499927ed95832537bd8897ed13bad7f47fb9b3570fe4 |
ENaCs are also expressed in the cardiovascular system, and their activation promotes cardiovascular fibrosis, vascular dysfunction, and arterial stiffening ( 222 , 225 ). Reducing effects of excess aldosterone by blocking MRs or inhibiting ENaC activation could attenuate PA-induced hyper - tension, sodium reabsorption,... | 70 | 32 | 32 | 051ae5aecff30d643681c0939959789ab81dbb4b29e5210b004a528187a88057 |
This suggests the potential utility of ENaC inhibitors like ami - loride and triamterene in the treatment of individuals with PA. Question 10. Should epithelial sodium-channel inhibitors vs mineralocorticoid receptor antagonists (steroidal and nonsteroidal) be used for medical treatment of primary aldosteronism? | 70 | 32 | 32 | 959d60a0d846ffe9b95efb09f9f72812cd6577bc9f302d1dda6e4f689f54c142 |
2484 The Journal of Clinical Endocrinology & Metabolism , 2025, Vol. 110, No. 9 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of Wisconsin System user on 20 February 2026 | 62 | 32 | 32 | 67a93d39ed14cbe73db0a48bcfb9c1464f43c2b441acf82b25b422cfa435f320 |
Recommendation 10 For individuals with primary aldosteronism (PA) receiv - ing PA-specific medical therapy, we suggest using min - eralocorticoid receptor antagonists (MRAs) rather than epithelial sodium-channel (ENaC) inhibitors (amiloride, triamterene) (2 | ⊕ OOO). | 76 | 33 | 33 | 041829af4d08e7242c71bfb568f9f70365b0008072a18b0f947d1fbfcf321fd1 |
Technical remark: • The recommendation (see Fig. 3 ) does not apply to clinical conditions in which spironolactone is contra - indicated (eg, hyperkalemia, advanced renal impair - ment, or pregnancy) or if a non-spironolactone MRA were indicated for other non-PA indications (eg, heart failure). | 72 | 33 | 33 | db2bff426e742c44fabd9ae96ab1b1bdfa50d88f7855917e29ecd2a5392ba59e |
Summary of the Evidence The meta-analysis results, a detailed summary of the evidence and Evidence to Decision (EtD) tables can be found online at https:/ /guidelines.gradepro.org/profile/CssZc_4Ppmg . | 55 | 33 | 33 | cdffa6c72e7310e06560153e5e9a80d1edfaf4d5405702952f6db5a8fe522c5d |
Benefits and Harms The panel voted for the following patient-important outcomes for Question 10 decision making: 1) percent of individuals achieving BP control, 2) number of antihypertensive agents, 3) dosage of antihypertensive agents, 4) systolic BP (SBP) level, 5) adverse car - diovascular events (MACEs), 6) atrial ... | 120 | 33 | 33 | 072a781b851d308970c09c98e0d886c5127852a964cb7c52c411cb172412faa1 |
The systematic review did not find any studies directly com - paring ENaC inhibitors vs MRAs in the medical treatment of PA, although a few studies compared ENaC inhibitors and spironolactone (but not eplerenone) in resistant hypertension. | 54 | 33 | 33 | 3da7f1c4e0959c9c8aa4f7144652c9df155118152a6d6e5700cc6c21530a9841 |
Because most individuals with resistant hypertension have PA, we used these studies as indirect evidence of hyperaldosteron - ism ( 40 , 164 ). The largest study was a sub-study of the PATHWAY-2 study, which was a randomized, double-blind crossover trial in individuals with resistant hypertension ( 19 ). | 63 | 33 | 33 | b10a35714e2675ac2f127265060126ace883b8a17d1b8664656c3e1e9ebfb307 |
Results showed similar BP-lowering effects of spironolactone and amiloride. In the spironolactone, amiloride, losartan, and thiazide (SALT) double-blind crossover trial in individuals with low-renin hypertension and elevated aldosterone to re - nin ratio (ARR), spironolactone and high-dose amiloride had similar antihyp... | 232 | 33 | 33 | 60e7147feed74d71ea1869cd6c3803708fadc2e2cde80a0c97078a3aaa5d9895 |
Together, these studies in resistant hypertension suggest ENaC inhibitors as a viable substitute for spironolactone when spironolactone is not tolerated ( 233 , 234 ). Beyond similar antihypertensive effects, both amiloride and spironolactone equally improved quality of life (QOL) in individuals with PA ( 234 , 5 ). | 73 | 33 | 33 | 97d71837aae14c220cc5c98d85d8f1ac9434edeb85340a52518f15028d5c9d82 |
Amiloride may be an effective antihypertensive drug in indi - viduals with PA. However, whether the effects are superior or not to MRAs is unknown because head-to-head trials compar - ing them in PA are lacking. | 54 | 33 | 33 | 7c716430e8d1777effab778d9ed1cd9d81316c03957073781b8cbb7a87028a9a |
In a small clinical study in individ - uals with PA, low-dose amiloride controlled BP within 1 to 4 weeks of initiation, with effects sustained for up to 20 years ( 227 ). | 42 | 33 | 33 | 3b399d475419602f2f79f52434a8ceca3c89f7d791e9e6fa7770680778fc92fd |
This was associated with improved vascular function (pulse-wave velocity-indicating cardiac output, vascular re - sistance, and arterial stiffness) and no cardiovascular events. Amiloride at higher doses corrected hypokalemia and normal - ized BP in individuals with PA ( 228 ). | 60 | 33 | 33 | a77a9860f4ae7d0a6072a0dfe61e52415cc4e30b2eaa755ec98eeef2210d2f0a |
A major assumption (as required with reliance on indirect evidence) is that both ENaC inhibitors and MRAs would like - ly yield equivalent clinical outcomes based on observations that they probably yield similar BP reductions in a PA popula - tion. | 48 | 33 | 33 | 8484401ab96e0d76feca66f8c8357998c60a5e168a5108f0d075e250884288c9 |
However, ENaC inhibitors do not block aldosterone dir - ectly; therefore, the impact of ENaC inhibitors and MRAs on aldosterone-specific end-organ injury may differ. | 42 | 33 | 33 | 96b76ed5d21a299c8c9ed9386d8b8ac4638f490f880e8dfe8ca5e79a7f1ba975 |
Evidence to Decision Factors • Cost-effectiveness data do not exist for ENaC inhibitors in medical PA treatment. However, cost estimates in the United States demonstrated equally low prices for equipo - tent amiloride and spironolactone. | 51 | 33 | 33 | f6df0d9ee07f0aa00b037b7bb65f2fad5115b16ab689befd44bdc058e211c9d2 |
• Accordingly, amiloride as an alternative to spironolactone may be cost-neutral. (See Question 9 for discussion of cost-effectiveness of spironolactone.) • Since the clinical impact (BP-lowering) of ENaC inhibitors is the same as spironolactone and given their similar low costs, similar cost-effectiveness is expected ... | 92 | 33 | 33 | f91d8c00602e94b7c9ea028223418bd65aee50bca9bbfe2ce23d5d2f49030807 |
• Cost neutrality may be especially relevant in Black individ - uals who are more likely to have low-renin hypertension ( 231 ). Some evidence exists that a significant proportion of these individuals may also have a Liddle-syndrome-type biochemical phenotype, which is strongly responsive to ENaC inhibitors ( 235 ). | 65 | 33 | 33 | 991d0b8b9d8d3006b49606ab20e753f8bcc306e88ac90b1598d1ea9ad8f1de14 |
• Accordingly, inclusion of ENaC inhibitors as an option for low-renin/PA hypertension could increase health equity. Justification for the Recommendation Although the evidence is limited and indirect, amiloride seems to be as effective as spironolactone in reducing BP in individuals with resistant hypertension, which t... | 80 | 33 | 33 | 7065d6bbcf75e759179b2ce6438a231424764e416615edc6323bbe5a1d338ec2 |
Both drugs are low cost and both improve QOL. In addition to a lack of direct clinical evidence to recommend the ENaC amiloride over the MRA spironolactone as first- line therapy, questions remain as to whether amiloride would offer all the same benefits as an MRA. | 65 | 33 | 33 | 3951e43d7380abfd5cf459450ef860df79b780225718768e511a16b40ac5ca19 |
There is some justification that MRA should be the preferred treat - ment in PA based on a small study of 10 individuals with hypertension and supranormal aldosterone secretion in which spironolactone (400 mg/day) had greater BP-lowering ef - fects than did amiloride (40 mg/day) as well as on the clear evidence that MR... | 123 | 33 | 33 | 3f6f10e661a06b0400f908f21d36504f60b0c6dd405534e30279ad5380b79eb1 |
The Journal of Clinical Endocrinology & Metabolism , 2025, Vol. 110, No. 9 2485 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of Wisconsin System user on 20 February 2026 | 62 | 33 | 33 | b23793cd00055ca31411eaee5d32dd88ffe43fe95c27672ee165a1862ffcb3d8 |
Comments and Future Research Considerations Many gaps in knowledge need to be addressed through robust clinical studies before ENaC inhibitors could be considered a replacement, or add-on therapy, to MRAs, including: | 41 | 34 | 34 | 8af57a9c4bb624080832e06efb4ae1791cfeab1867cbbae5e264f33063fd68e2 |
• Comparing ENaC inhibitors vs MRAs in PA • Studying the potential long-term effects of ENaC inhibi - tors on end-organ damage in PA, including cardiac, vascu - lar, and renal fibrosis • Considering diverse populations of PA, including those who are salt-sensitive Acknowledgments The Endocrine Society and the Guideline... | 109 | 34 | 34 | 7646f4c76b34521b99f2de03812a73ae10ed3d931db0bf4acd3eefb002bc56c6 |
The panel thanks Endocrine Society staff including Maureen Corrigan, MA, Elizabeth York, MPH, Laura Mitchell, MA, and Emma Goldberg, PhD, for their expert guidance and assistance with all aspects of guideline develop - ment. | 46 | 34 | 34 | d0126f40ab64c82e5ffcd4d673a906815beebf4d502dac83ae10439bf394760c |
We also thank the numerous contributors from the Mayo Evidence-Based Practice Center, especially Magdoleen Farah, MBBS, for their contribution in conduct - ing the evidence reviews for the guideline. | 40 | 34 | 34 | cc0143f49e4175d4a8b97350a829b9e0ed24f3e75a0d5879b48b571252aa9a1b |
We are grateful to Robert Carey, MD, for his contributions to this guideline and to the field. Funding Funding for the development of this guideline was provided by The Endocrine Society. No other entity provided financial support. | 43 | 34 | 34 | 783195cda9ffd9914d645065974645b4cb42e957ac979d0b357b2d92c1a13591 |
Disclaimer The Endocrine Society ’ s clinical practice guidelines are devel - oped to be of assistance to endocrinologists by providing guidance and recommendations for particular areas of practice. The guidelines should not be considered as an all-encompassing approach to individual care and not inclu - sive of all pr... | 72 | 34 | 34 | 848f964763c9686536fdf6cf0ad268f8978e16fd2506f83d17525051370214b9 |
The guidelines cannot guarantee any specific outcome or successful treatment, nor do they establish a standard of care. The guidelines are educational tools, not medical advice, and are not intended to dictate the treatment of a particular individual. | 43 | 34 | 34 | fc2e6040c7b202f1f85c74c4f677dfc7ae6ab4c5038e2a0619fe084817496a3d |
Treatment decisions must be made based on the in - dependent judgment of health care clinicians and each per - son ’ s individual circumstances. The Endocrine Society makes every effort to present accurate and reliable informa - tion, and this guideline reflects the best available data and understanding of the science ... | 70 | 34 | 34 | 28cbf4a65b56509fd5fc0bba2ef5566cf261afc5b9529991185689358656dad1 |
The results of future studies may require revisions to the recommendations in this guideline to reflect new data. This publication is provided “ as is ” and the Society makes no warranty, express or implied, regarding the accuracy and reliability of these guidelines and specifically excludes any warranties of merchanta... | 78 | 34 | 34 | b2296addf6f3fc2029964c41aa5bfb479ef0022d010026098875268a017d6357 |
The Society, its officers, directors, members, em - ployees, and agents (including the members of the Guideline Development Panel) shall not be liable for direct, indirect, special, incidental, or consequential damages, including the interruption of business, loss of profits, or other monetary damages, regardless of wh... | 122 | 34 | 34 | 2dd66c0ad0884efba5a45ce0e692752bd7b71ad4c307cf5a2075c9e18835e7d7 |
Appendix A. Guideline Development Panel makeup, roles, and management plans Summary • Total number of Guideline Development Panel (GDP) members = 13 • Percentage of total GDP members with relevant (or poten - tially relevant) COI = 31% Individual Disclosures, Conflicts, and Management Strategies Chair: | 66 | 34 | 34 | b2ef40aa652bbfc5a6b184a8f1699526f4c70b6de0ec57366b9d4661e6c3ce6b |
Gail K. Adler, MD, PhD Brigham and Women ’ s Hospital Expertise: Adult endocrinology Disclosures (2021-2025): • National Institutes of Health, Research Funding (various topics) • Tersus Life Sciences, LLC, Research Funding (insulin sen - sitivity and lipogenesis) • American Heart Association, Member of Programming Comm... | 95 | 34 | 34 | 721a599e32391b75ae0eea9ad5a905b1e3fa848eb46abceff3a442d4744b7cbf |
Representative Chair Gail Adler No Co-Chair Michael Stowasser No Members Ricardo Correa Yes AACE Nadia Khan No ISH Gregory Kline No Michael McGowan No PAF Paolo Mulatero Yes ESH Rhian Touyz No AHA Anand Vaidya Yes Tracy Williams No ESE Jun Yang No William Young Yes Maria Christina Zennaro No Methodologists M. | 81 | 34 | 34 | 1cb17a1a4c435824c74a0337264f17dc7261b97e9e5435ada6e000062842df9b |
Hassan Murad No Juan P. Brito No Abbreviations: AACE, American Association of Clinical Endocrinology; AHA, American Heart Association; COI, conflict of interest; ESE, European Society of Endocrinology; ESH, European Society of Hypertension; ISH, International Society of Hypertension; PAF, Primary Aldosteronism Foundati... | 82 | 34 | 34 | 20e66429f9eb0c3d8bb7224e493764f91ff9c254d1e7923ab81ad14f3b3312b0 |
2486 The Journal of Clinical Endocrinology & Metabolism , 2025, Vol. 110, No. 9 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of Wisconsin System user on 20 February 2026 | 62 | 34 | 34 | 30609cbe4901d3c294c19e8d0e97f339f347ca7f32fc0aeb5e68a610029680bd |
• Paris-Cardiovascular Research Center (PARCC) INSERM U970, France, Member of Scientific Advisory Board 2012-2022 Open Payments Database: https:/ /openpaymentsdata.cms. gov/physician/1040596 Assessment and Management: • No COI relevant to this CPG. • No management required. Co-Chair: Michael Stowasser, MBBS, FRACP, PhD... | 171 | 35 | 35 | 46329738d35441805c8fca5464e51469a617889e390259030d2a4b92ec7a147c |
• Dynamed • American Medical Association IMG section • American Federation of Medical Research • Association of Program Director of Endocrinology • Maricopa Medical Association • ModernaTX, Consulting • Ascendis Pharma, Speaker • Neurocrine Biosciences, Consulting • NovoNordisk, Consulting • Boehringer Ingelheim (Boehr... | 236 | 35 | 35 | 0a8e7d92242b8795c3278524cbdabc441a92a6da537dc099e2843155d7d767f9 |
https:/ /openpaymentsdata.cms.gov/ physician/1323034 Assessment and Management: • Dr. Correa was assessed at the initiation of guideline develop - ment of having no industry relationship relevant to the guide - line. | 48 | 35 | 35 | 557f5afb55d4ffd2d8e82f31b5ab05e9e66098b9e2956c7c9b54a26b572c6348 |
However, near the end of the development of the guideline, it came to the attention of the Clinical Guidelines Committee Chair that he had 2 consulting entries in Open Payments with 2 companies that had potential relevance to the guideline, Boehringer Ingelheim and Pfizer. | 54 | 35 | 35 | 16a402e1f66fb87d5724ad62a89ec7aa3a9d9cdd41493780a08edcfa5c302e43 |
Upon assess - ment of the relationships, the amounts were considered min - imal and to not need further mitigation. Nadia Khan, MD University of British Columbia Expertise: Adult hypertension Disclosures (2023-2025): | 47 | 35 | 35 | 1e5e26711ca39229f093d952a1e84e66dab8c002fc620a89bbd2adfca35cdfe0 |
• Canadian Institutes for Health Research, co-investigator • Brain Canada, co-investigator • Heart and Stroke Foundation of Canada, co-investigator • International Society of Hypertension, Executive Board Member Open Payments Database: | 47 | 35 | 35 | 09a78c289bd2710da34e599a6310b1fe8a70ddf28e6cbcef4ce295e051100408 |
n/a Assessment and Management: • No COI relevant to this CPG. • No management required. Gregory Kline, MD Alberta Health Services Expertise: Adult endocrinology Disclosures (2023-2025): • Primary Aldosteronism Foundation, Medical Advisory Board Member Open Payments Database: n/a Assessment and Management: • No COI rele... | 109 | 35 | 35 | e3a0150cec0debdc27f2b2cfba8023f679d70f92e9dd291f716ac11bcd6b5033 |
• Cemosoft, consultant • Brainiest AI Technology, VP and Architect • Primary Aldosteronism Foundation, various leadership roles Open Payments Database: n/a Assessment and Management: • No COI relevant to this CPG. • No management required. Paolo Mulatero, MD University of Torino Expertise: Adult hypertension Disclosure... | 79 | 35 | 35 | f6fc1e3d18a11a85edc0ea457ddb1f5faa2c00c44af612b5fc38b4c910565eb3 |
• Diasorin (Diasorin manufactures and markets Liaison ® Hypertension Diagnostic Solution, which includes aldos - terone and renin assays.), speaker Open Payments Database: | 42 | 35 | 35 | 74e32d3dea25e228738c6ddc8bbb5535ce6830452cab51d47d99993662f934d1 |
n/a Assessment and Management: • Dr. Mulatero has an industry relationship relevant to this CPG. • Dr. Mulatero was allowed to participate on the GDP be - cause he is a renowned expert in the area of primary aldos - teronism, and since he was nominated by the European Society of Hypertension. | 71 | 35 | 35 | 479c15b0ec2a8e7220d7d5993b5195a290cec60ad898b8261aa80045638213a8 |
• Divestment: None required. • COI management: Mulatero ’ s relationship with Diasorin was deemed potentially relevant to questions re - lated to diagnostic testing. | 39 | 35 | 35 | a2da807b68f77c696d26744117610334fbfa6e67ab0ceb8431a93f7fef0703d4 |
Mulatero was not involved in systematic reviews for PICO questions directly related to the above considerations. Mulatero did not vote The Journal of Clinical Endocrinology & Metabolism , 2025, Vol. | 43 | 35 | 35 | ca996079555ded887255f1cd1624d8c55dd606511c44a2cca289643b5b078f0a |
110, No. 9 2487 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of Wisconsin System user on 20 February 2026 | 46 | 35 | 35 | 7bb8a4e764367bac6835d5c6daed5859bcf138c719b439ca3e68c03fe8016b8c |
on matters directly related to the above considerations. Mulatero did not draft guideline sections directly re - lated to the above considerations. All GDP participants were made aware of Dr. Mulatero ’ s potentially relevant industry relationship. Rhian Touyz, MBBCh, MSc, PhD McGill University Expertise: Adult hyperte... | 77 | 36 | 36 | 585d8e95be804635963cfb09b2fddfa68ebd15ef116547737d668f8c79ba7996 |
• American Heart Association, Editor-in-Chief Hypertension journal, Council on Hypertension • European Society of Cardiology, Co-chair, 2024 ESC guidelines on elevated blood pressure and hypertension Open Payments Database: | 44 | 36 | 36 | df83ddbf5b2fd823545d84239573155e0e528f7f5cecfb7b74bf3271a5dbfa31 |
n/a Assessment and Management: • No COI relevant to this CPG. • No management required. Anand Vaidya, MD Brigham and Women ’ s Hospital Expertise: Adult endocrinology Disclosures (2021-2025): | 53 | 36 | 36 | 004426b552757b8b83d6e2017871b6abd768f8f395788205e92d8c2592aff80f |
• Mineralys Therapeutics (Mineralys Therapeutics is devel - oping lorundrostat, an aldosterone synthase inhibitor.), Advisory Board • HRA Pharma, Advisory Board • Corcept, Advisory Board, Consulting Open Payments Database: | 54 | 36 | 36 | b1391be302ecd20d4cb214c38a51c38977e87de15405217d26b02aa3536ca57d |
n/a Assessment and Management: • Dr. Vaidya has an industry relationship relevant to this CPG. • Dr. Vaidya was allowed to participate on the GDP be - cause he is a renowned expert in the area of primary aldosteronism. | 55 | 36 | 36 | db55a6242ad92fa3f874e2c37ba1c132633d6da52244c38970bfc01ee68f597c |
• Divestment: Vaidya divested from advisory board par - ticipation with relevant companies prior to initiation of the guideline. • COI management: Vaidya ’ s relationship with Mineralys Therapeutics was deemed potentially relevant to questions re - lated to medical treatment of primary aldosteronism. | 67 | 36 | 36 | 651a8411ee9f84f5fa8b39602c793aa7f436f5b8f0010cb4687092c0340f48c0 |
Vaidya was not involved in systematic reviews for PICO questions directly related to the above considerations. Vaidya did not vote on matters directly related to the above considerations. Vaidya did not draft guideline sections directly related to the above considerations. All GDP partici - pants were made aware of Dr.... | 161 | 36 | 36 | 525dbda72f7889028b7d46b503dfff742ee7c04854b1840f1a589f28255ae95b |
• Primary Aldosteronism Foundation, Patient Engagement Officer • New Zealand Health and Disability Commission, Expert • Endocrine Society, Annual Meeting Steering Committee Member • National Hypertension Taskforce, Member Open Payments Database: | 45 | 36 | 36 | 8363e3c9cfac2d621a67e570585e110ca2f9f8b556c3b7f8e673f3fc95d59dfe |
n/a Assessment and Management: • No COI relevant to this CPG. • No management required. William Young, MD Mayo Clinic Expertise: Adult endocrinology Disclosures (2021-2025): | 45 | 36 | 36 | 079e39755be1e1782f357aaa32af26833e5c9835fee6dd678ce4488fe544f8c4 |
• Bayer AG (Bayer manufactures and markets the anti- hypertensive agents Pritor ® (telmisartan), Adalt LA ® (nifedipine), Baycaron ® (mefruside), and Adempas ® (riociguat), and the mineralocorticoid receptor antagon - ist Kerendia ® (finerenone).), Consulting, Data Safety Monitoring Board • AstraZeneca (AstraZeneca man... | 212 | 36 | 36 | 46d889fa7a592981890ced65912ea80e86a63bd6bf96ef555400882e0631029e |
https:/ /openpaymentsdata.cms.gov/ physician/1145085 Assessment and Management: • Dr. Young has an industry relationship relevant to this CPG. • Dr. Young was allowed to participate on the GDP because he is a renowned expert in the area of primary aldosteronism. | 63 | 36 | 36 | dd9fbaccf0418bed01fc859f588347bfb45b28433acfbb44ed4b2feab94b7576 |
• Divestment: None required. • COI management: Young ’ s relationships with Bayer AG and AstraZeneca were deemed potentially relevant to questions related to medical treatment of primary al - dosteronism. | 45 | 36 | 36 | c050343832140cc2604da17589057dd186f14e559149598d0b38114037903a59 |
Young was not involved in systematic reviews for PICO questions directly related to the above considerations. Young did not vote on matters dir - ectly related to the above considerations. Young did not draft guideline sections directly related to the above considerations. All GDP participants were made aware of Dr. Yo... | 87 | 36 | 36 | 37d1a302a782b6110e7966fd843d5e2ab67212e606ff836af583d26d3df0b63b |
9 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of Wisconsin System user on 20 February 2026 | 40 | 36 | 36 | 86d3541f16c4cf3f3990fa58d424f397068a88b4c212a690d7cd989da5201309 |
Maria Christina Zennaro, MD, PhD Université Paris Cité, Inserm, PARCC Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique Expertise: Adult endocrinology Disclosures (2022-2025): • Springer Nature, Associate Editorial Board, 2022 • French Society of Endocrinology, Leadership • ... | 447 | 37 | 37 | 7ba4d262a2e1c732a2085c8c16f89106a4fcce0026619074385c7caae127d70d |
(Olmesartan medoxomil), Nilemdo ® (bempedoic acid) and Nustendi ® (bempe - doic acid and ezetimibe), and is developing mineralo - corticoid receptor inhibitor esaxerenone.): Speaker (b) Pfizer manufactures and markets aldosterone antag - onist and Aldactone ® (spironolactone) and the anti- hypertensive agents Accupril ... | 450 | 37 | 37 | 6b7ddfe7091ec92867117995124c93821d7315820f646c5bc4376d127cd47b9c |
Moretti C, et al. Cardiovascular events and target organ damage in primary aldosteronism com - pared with essential hypertension: a systematic review and meta- analysis. Lancet Diabetes Endocrinol . 2018;6(1):41-50. 3. Tan YK, Kwan YH, Teo DCL, et al. Improvement in quality of life and psychological symptoms after trea... | 333 | 37 | 37 | 14be73b3ddbbf89f8251f8d564e5a703b1604787e93b94d5aa1d9a9fbe79eaf4 |
Eur Heart J . 2024;45(38): 3912-4018. 7. Hundemer G, Curhan G, Yozamp N, Wang M, Vaidya A. Cardiometabolic outcomes and mortality in medically treated The Journal of Clinical Endocrinology & Metabolism , 2025, Vol. 110, No. 9 2489 Downloaded from https://academic.oup.com/jcem/article/110/9/2453/8196671 by University of... | 113 | 37 | 37 | 14339f150a040133ad29ff1b72eb3d9856a04a0f442693e6cc73acd1c94fce62 |
primary aldosteronism: a retrospective cohort study. Lancet Diabetes Endocrinol . 2018;6(1):51-59. Hundemer GL, Curhan GC, Yozamp N, Wang M, Vaidya A. | 50 | 38 | 38 | d554a0dfe0d5d4539a6105e76ae80bef797df234b6fbc38b4acb7cd401e0981d |
Renal outcomes in medically and surgically treated primary aldos - teronism. Hypertension . 2018;72(3):658-666. Hundemer GL, Curhan GC, Yozamp N, Wang M, Vaidya A. | 54 | 38 | 38 | 8bf4dbe4636273dfdd458ccda419c248b58252da85a3d34dddbc585824c43b79 |
Incidence of atrial fibrillation and mineralocorticoid receptor ac - tivity in patients with medically and surgically treated primary al - dosteronism. JAMA Cardiol . 2018;3(8):768-774. McCartney CR, Corrigan MD, Drake MT, et al. Enhancing the trustworthiness of the Endocrine Society ’ s clinical practice guide - lines... | 102 | 38 | 38 | f69d6b372d8f3c032b785036a0c2370fed88eeca72c605fbaa6d8bc90eb0a5c4 |
Swiglo BA, Murad MH, Schünemann HJ, et al. A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommenda - tions, assessment, development, and evaluation system. | 63 | 38 | 38 | ddb855a31d53daf298c3d793eb9409d831c25f6a9d57af6fbc9ec0c4ad03a68e |
J Clin Endocrinol Metab . 2008;93(3):666-673. Schünemann HJ, Broz ̇ ek J, Guyatt GH, Oxman AD. | 43 | 38 | 38 | 43229e1442bea4f502554d8d642491b032fabcba3b3bf4306246f2e9c7af7cef |
GRADE hand - book for grading quality of evidence and strength of recommenda - tions. https://gdt.gradepro.org/app/handbook/handbook.html 13. | 41 | 38 | 38 | e430d226c0ab22f9ae83c34e98e1cb77b37c2a15f203a48d82fc47121bf38671 |
Schünemann HJ, Cushman M, Burnett AE, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: prophylaxis for hospitalized and nonhospital - ized medical patients. Blood Adv . 2018;2(22):3198-3225. Alonso-Coello P, Oxman AD, Moberg J, et al. GRADE Evidence to Decision (EtD) frame... | 193 | 38 | 38 | 479554616939cbd10906da2a80af229bedb29468baf459268865e8ce52bce59a |
Standardized wording to im - prove efficiency and clarity of GRADE EtD frameworks in health guidelines. J Clin Epidemiol . 2022;146:106-122. Andrews JC, Schünemann HJ, Oxman AD, et al. GRADE guide - lines: Going from evidence to recommendation-determinants of a recommendation ’ s direction and strength. J Clin Epidemio... | 153 | 38 | 38 | 3d181c00935fb7bbb228083a38b5b4d8ad8aec9ef9e4a6d6797c24cf325be632 |
Endocrine and haemodynamic changes in resistant hypertension, and blood pres - sure responses to spironolactone or amiloride: the PATHWAY-2 mechanisms substudies. Lancet Diabetes Endocrinol . 2018;6(6): 464-475. Williams B, MacDonald TM, Morant S, et al. | 69 | 38 | 38 | 9339cebfdaef2b95e59bf7ed7e7046ac1c56fe3aac5efcf427f9a12639928406 |
Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treat - ment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet . 2015;386(10008):2059-2068. Carey RM, Douglas JG, Schweikert JR, Liddle GW. The syn - drome of essential hypertension and suppr... | 140 | 38 | 38 | 95a8d1f134ea323a981902187524833a2e225237a7d521a727637b2b9acddc7b |
Effects of eplere - none versus losartan in patients with low-renin hypertension. Am Heart J . 2005;150(3):426-433. Brown JM, Siddiqui M, Calhoun DA, et al. The unrecognized prevalence of primary aldosteronism: a cross-sectional study. Ann Intern Med . 2020;173(1):10-20. Cornu E, Steichen O, Nogueira-Silva L, et al. | 100 | 38 | 38 | 196b89130bc0a89f4cdcf31c0d6a0f99b7f43f6bc16c474ef67b711705d93681 |
Suppression of aldosterone secretion after recumbent saline infusion does not exclude lateralized primary aldosteronism. Hypertension . 2016; 68(4):989-994. Parksook WW, Brown JM, Omata K, et al. The spectrum of dys - regulated aldosterone production: an international human physi - ology study. J Clin Endocrinol Metab ... | 219 | 38 | 38 | f82fa300649c542e90cd7a290ac08ee7b0ecb8078d4ce87fa2e2a3d668c0467b |
Comparison of surgery and prolonged spironolactone therapy in patients with hypertension, aldosterone excess, and low plasma renin. Br Med J . 1972; 2(5816):729-734. Fourkiotis V, Vonend O, Diederich S, et al. | 62 | 38 | 38 | f992b61a730301fd2a54f1682cfe5d19e3767b18c7a99704340fbe2ecc04b938 |
Effectiveness of epler - enone or spironolactone treatment in preserving renal function in primary aldosteronism. Eur J Endocrinol . 2013;168(1):75-81. Saiki A, Otsuki M, Tamada D, et al. | 59 | 38 | 38 | 977341091cb159cbee649605faaecbb0f73bf3627066493502815a449ff570e9 |
Increased dosage of MRA im - proves BP and urinary albumin excretion in primary aldosteron - ism with suppressed plasma renin. J Endocr Soc . 2022;6(1): bvab174. Schneider H, Sarkis AL, Sturm L, et al. | 60 | 38 | 38 | b581dba11569cfdfa36f213bd87d1745342c045fc6dea06a84eac45825762f7b |
Moderate dietary salt re - striction improves blood pressure and mental well-being in pa - tients with primary aldosteronism: the salt CONNtrol trial. J Intern Med . 2023;294(1):47-57. Katsuragawa S, Goto A, Shinoda S, et al. | 69 | 38 | 38 | 6040faed7657159e36f3932518083fb625f4068c5c162406acf06ed5356624fe |
Association of reversal of renin suppression with long-term renal outcome in medically treated primary aldosteronism. Hypertension . 2023;80(9):1909-1920. Nakano Y, Murakami M, Hara K, et al. | 56 | 38 | 38 | d288c0f9a079f5c859a648cee7230cb1d473f4680868597f20ed051fae9a91a5 |
Long-term effects of pri - mary aldosteronism treatment on patients with primary aldoster - onism and chronic kidney disease. Clin Endocrinol (Oxf) . 2023; 98(3):323-331. Monticone S, Burrello J, Tizzani D, et al. Prevalence and clinical manifestations of primary aldosteronism encountered in primary care practice. J Am... | 212 | 38 | 38 | c69f53f2f5b1dfea15df992b1ee46aca1b41ebf4f5a937380b08620ebb836e0c |
A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive pa - tients. J Am Coll Cardiol . 2006;48(11):2293-2300. | 42 | 38 | 38 | 110b04220a81669980a7948599dab678c925264d6b936676bfea925f965e974f |
Käyser SC, Dekkers T, Groenewoud HJ, et al. Study heterogeneity and estimation of prevalence of primary aldosteronism: a system - atic review and meta-regression analysis. J Clin Endocrinol Metab . 2016;101(7):2826-2835. Buffolo F, Monticone S, Burrello J, et al. Is primary aldosteronism still largely unrecognized? Hor... | 199 | 38 | 38 | 8433395f301843d8f01626703edf1d42c73bd49c772990584e88066562cfb6ef |
Parasiliti-Caprino M, Lopez C, Prencipe N, et al. Prevalence of primary aldosteronism and association with cardiovascular com - plications in patients with resistant and refractory hypertension. | 50 | 38 | 38 | 4217386d07e2b61c0088e660b2bca8e783e7093743f3bea71c62d40a1698e6f9 |
J Hypertens . 2020;38(9):1841-1848. Burrello J, Monticone S, Losano I, et al. Prevalence of hypokal - emia and primary aldosteronism in 5100 patients referred to a ter - tiary hypertension unit. | 64 | 38 | 38 | b7cb37a446a2ed742bf66e240c4d0d6d662c4608a65b6f9dadf8fbf87d1a16a8 |
Hypertension . 2020;75(4):1025-1033. Sconfienza E, Tetti M, Forestiero V, Veglio F, Mulatero P, Monticone S. | 44 | 38 | 38 | fd888c5b0007ac7acab12ce4518551a8e803dd3a61ba6b62c4b035495fd5b82d |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.