Conclusion

Spironolactone, an aldosterone antagonist, is probably the first treatment for primary hyperaldosteronism.101 In Lim et al’s study of 28 patients with primary aldosteronism, 48% achieved BP control 140/90 mmHg and 48% were treated with spironolactone therapy alone.102 Other treatments appear less effective. The value of eplerenone in BP control is being tested in trials. It is a more selective competitive aldosterone receptor antagonist offering the promise of less anti-androgen side effects.