ArticleThe Journal of clinical endocrinology and metabolism2019
Adrenal Vein Sampling Lateralization Despite Mineralocorticoid Receptor Antagonists Exposure in Primary Aldosteronism.
Article in The Journal of clinical endocrinology and metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Adrenal Vein Sampling for Primary Aldosteronism: Recommendations From the Australian and New Zealand Working Group.Clinical endocrinology · 2025Guideline
- Subtyping of Primary Aldosteronism by Adrenal Venous Sampling.Endocrine reviews · 2025Review
- Adrenal venous sampling outcomes with and without mineralocorticoid receptor antagonists in primary aldosteronism.BMC endocrine disorders · 2025Article
- Nationwide, Pragmatic, Direct-to-Patient Primary Aldosteronism Testing Program.Hypertension (Dallas, Tex. : 1979) · 2025Article
- Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications.Current hypertension reports · 2024Review
- Subtype Identification of Surgically Curable Primary Aldosteronism During Treatment With Mineralocorticoid Receptor Blockade.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Bilateral Nephrectomy for Resistant Hypertension and Secondary Aldosteronism in a Hemodialysis Patient: A Case Report.Internal medicine (Tokyo, Japan) · 2024Article
- Pitfalls in the preoperative and postoperative workup of patients with primary aldosteronism.Gland surgery · 2024Article
- Biomarkers to Guide Medical Therapy in Primary Aldosteronism.Endocrine reviews · 2024Review
- Diagnosis and management of primary hyperaldosteronism in patients with hypertension: a practical approach endorsed by the British and Irish Hypertension Society.Journal of human hypertension · 2024Review
- 2023 Korean Endocrine Society Consensus Guidelines for the Diagnosis and Management of Primary Aldosteronism.Endocrinology and metabolism (Seoul, Korea) · 2023Article
- Efficacy of Oral Furosemide Test for Primary Aldosteronism Diagnosis.Journal of the Endocrine Society · 2023Article
- Primary Aldosteronism: State-of-the-Art Review.American journal of hypertension · 2022Article
- Imaging or Adrenal Vein Sampling Approach in Primary Aldosteronism? A Patient-Based Approach.Tomography (Ann Arbor, Mich.) · 2022Review
- Primary aldosteronism - a multidimensional syndrome.Nature reviews. Endocrinology · 2022Review
- The spectrum of plasma renin activity and hypertension diseases: Utility, outlook, and suggestions.Journal of clinical laboratory analysis · 2022Review
- High Prevalence of Autonomous Aldosterone Production in Hypertension: How to Identify and Treat It.Current hypertension reports · 2022Review
- Approach to the Patient with Primary Aldosteronism: Utility and Limitations of Adrenal Vein Sampling.The Journal of clinical endocrinology and metabolism · 2021Article
- The Effect of Antihypertensive Medications on Testing for Primary Aldosteronism.Frontiers in pharmacology · 2021Review
- Mineralocorticoid Receptor Antagonists Decrease the Rates of Positive Screening for Primary Aldosteronism.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
Context: Many antihypertensive medications modulate the renin-angiotensin-aldosterone system, possibly skewing the diagnosis and subtyping of primary aldosteronism (PA). Particularly, mineralocorticoid receptor antagonists (MRA) might raise renin and stimulate aldosterone synthesis from nonautonomous areas, potentially obscuring lateralization on adrenal vein sampling (AVS). Withdrawal of MRA in severe PA, however, can precipitate hypokalemia and/or hypertension and therefore is not always practical. Objective: To assess the effects of MRA on the interpretation of AVS data. Design and Participants: A cohort study of all PA patients who underwent AVS at University of Michigan between January 2009 and January 2018 was conducted. Demographics, diagnostic, AVS, surgical pathology, and follow-up data were collected retrospectively. Results: Of 191 patients who underwent AVS, 51 (27%) were exposed to MRA at the time of the procedure. Plasma aldosterone concentration and the daily defined dose of antihypertensives were higher in patients taking vs those not taking MRA. Unilateral PA was more frequent in the MRA group, both precosyntropin and postcosyntropin (P < 0.05). The MRA group included two patients with unsuppressed renin, who demonstrated unequivocal AVS lateralization. To date, 86 patients underwent unilateral adrenalectomy, including 30 patients taking MRA during AVS. The proportion of clinical and biochemical success was not statistically different between patients exposed to and those not exposed to MRA during AVS (P = 0.17 and 0.65, respectively). Conclusion: Our data suggest that conclusive AVS lateralization is often achieved in patients with severe PA despite MRA use.
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