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Primary Aldosteronism Medical Treatment Outcomes (PAMO) Beyond 12 Months
Jun Yang1,2, Jessica Goi3, Jacopo Burrello3
1Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., R.L., P.J.F.).
Hypertension (Dallas, Tex. : 1979)
|July 22, 2026
Summary
Medical therapy for primary aldosteronism (PA) offers lasting benefits. Early detection and appropriate medication dosing are key to successful long-term treatment outcomes for hypertension.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Hypertension Research
Background:
- Primary aldosteronism (PA) is a prevalent, treatable cause of hypertension.
- Limited data exist on the long-term durability of medical treatment responses in PA beyond one year.
Purpose of the Study:
- To evaluate long-term biochemical and clinical outcomes of medical treatment for PA.
- To identify factors associated with sustained treatment response.
Main Methods:
- International, multicenter, observational cohort study (27 centers, 4 continents).
- Included adults with PA treated with mineralocorticoid receptor antagonists or epithelial sodium channel blockers (2016-2021) with ≥12 months follow-up.
- Classified responses (complete, partial, absent) using PA medical treatment outcomes criteria; identified determinants via ordinal logistic regression.
Main Results:
- 1292 patients (mean age 52) with median 34-month follow-up.
- At ≥12 months: 58.3% complete biochemical response, 20.8% complete clinical response; only 5% showed no response.
- Favorable biochemical response linked to lower baseline aldosterone/lateralization index, higher renin/potassium. Favorable clinical response associated with female sex, lower BMI, shorter hypertension duration, and no organ damage.
Conclusions:
- Targeted medical therapy for PA provides sustained biochemical and clinical benefits.
- Early disease detection and adequate dose titration are crucial for long-term treatment success.
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