Primary prevention

There are no known methods of primary prevention of primary aldosteronism. However, early detection (e.g., through screening of kin for familial hyperaldosteronism types I-IV) can facilitate early intervention such as dietary salt restriction, which may have the potential to delay or even prevent onset of hypertension in affected individuals, or at least permit more timely intervention when required.

Secondary prevention

Patients with primary aldosteronism (PA) have a higher risk of cardiovascular adverse events, atrial fibrillation, and chronic kidney disease than patients with essential hypertension.[28][66]​ Therefore, early diagnosis and initiation of specific treatment is essential to reduce the risk of complications. In addition to blood pressure control, suppressed renin levels are also associated with worse cardiovascular outcomes.​​[137]​ There is evidence that spironolactone is able to ameliorate non-BP-dependent adverse cardiovascular and renal effects of aldosterone excess.[58][61][123][124][125]​​ Lifestyle modifications (including maintenance of a healthy weight, regular exercise, avoidance of alcohol excess, dietary salt restriction, and smoking cessation) should be initiated in all patients. Dietary salt restriction may also reduce the dose of aldosterone blocking drug required. Patients should be screened for diabetes or dyslipidemia with fasting blood sugar and lipid levels. The prevalence of diabetes in people with PA is approximately 20%; around double the prevalence in the general population or matched hypertensive controls.[147][148]

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