Latest Treatment options for hyperaldosteronism
• Conn adenoma: Unilateral adrenalectomy, now often by laparoscopic surgery.
• Bilateral adrenal hyperplasia: Chronic therapy with an aldosterone antagonist. Spironolactone had superior efficacy in lowering blood pressure compared to eplerenone in one international clinical trial, but the latter has fewer adverse effects.
• For hyperaldosteronism related to sleep apnea: Spironolactone (or eplerenone) is effective in the vast majority of cases; continuous positive airway pressure is recommended for the signs and symptoms of sleep apnea.
• For glucocorticoid-suppressible hyperaldosteronism: Low-dose glucocorticoid.