Evidence map›Paper›PMID 40615697›Full record

SynthesisHypertension research : official journal of the Japanese Society of Hypertension2025

A systematic review to compare adrenalectomy and mineralocorticoid receptor antagonists in patients with unilateral primary aldosteronism.

Yuichi Yoshida, Kenichiro Kinouchi, Satoshi Nagai, Atsushi Sakima, Yoichi Takami, Hisatomi Arima, Kazutoshi Miyashita, Masashi Mukoyama

Abstract readSystematic ReviewComparative Study
PubMed Publisher
In one paragraph

Synthesis in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Yuichi Yoshida *Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan. y-yoshida@oita-u.ac.jp.
Kenichiro Kinouchi *Division of Endocrinology, Metabolism, and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. ken-k@keio.jp.
Satoshi NagaiDepartment of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan.
Atsushi SakimaHealth Administration Center, University of the Ryukyus, Nishihara Okinawa, Japan.
Yoichi TakamiDepartment of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Hisatomi ArimaDepartment of Preventive Medicine & Public Health, Fukuoka University, Fukuoka, Japan.
Kazutoshi MiyashitaDepartment of Internal Medicine, International University of Health and Welfare Mita Hospital, Tokyo, Japan.
Masashi MukoyamaDepartment of Nephrology, Omuta Tenryo Hospital, Omuta, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To date, no systematic review has examined whether adrenalectomy (ADX) or mineralocorticoid receptor antagonist (MRA) treatment is more effective in patients with unilateral primary aldosteronism (uPA). Comparing clinical and biochemical data before and after treatment, we performed a systematic review to determine whether either ADX or MRA treatment is superior to the other in patients with uPA. Article search was performed using the PubMed, Cochrane Library, and ICHUSHI electronic databases. A comparative analysis was performed when at least 3 articles were available in each outcome. The collected data were used to calculate the effect measures represented as mean difference (MD) or odds ratio (OR). Our search strategy identified 526 abstracts, of which 7 research papers were finally included in the analysis. ADX for uPA patients significantly reduced the incidence of cerebro-cardiovascular disease (OR 0.63 [95% confidence interval 0.46, 0.85]), lowered the systolic BP (-8.78 mmHg [-11.61, -5.95]), and increased the serum potassium levels (0.43 mmol/L [0.35, 0.51]) compared to MRAs. In conclusion, ADX is more effective than MRA treatment in patients with uPA, but with higher risk of increased serum potassium levels. Graphical abstract: ADX adrenalectomy, MRAs mineralocorticoid receptor antagonists, PA primary aldosteronism, SBP systolic blood pressure.

Indexed as

AdrenalectomyHyperaldosteronismMineralocorticoid Receptor AntagonistsHumansMineralocorticoid Receptor AntagonistsAdrenalectomyHypertensionMineralocorticoid receptor antagonistSystematic reviewUnilateral primary aldosteronism

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.