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Endocrinology

Hypertension   

Questions discussed in this category

Do you forgo adrenal imaging in a patient with primary hyperaldosteronism who has decided against surgery?
Do you have any concerns about missing an adrenal carcinoma if imaging is not pursued?
1 Answer available
When should you consider adding clonidine to an antihypertensive regimen for patients with advanced CKD?
Is there a certain estimated GFR threshold below which clonidine is to be avoided or used with caution ?
1 Answer available
What is the optimal BP target for patients with diabetes and hypertension to reduce their risk of MI/stroke?
2 Answers available
Is it a good practice to prescribe clonidine to take as needed for occasional severe blood pressure elevations?
2 Answers available
How do you approach checking an aldosterone to renin ratio in an outpatient with hypertension and hypokalemia that is difficult to correct with oral potassium replacement?
Would you check an aldosterone to renin ratio in the setting of hypokalemia, knowing that the result will be impacted by the potassium level?
2 Answers available
Are there instances when you would recommend against pursuing adrenal vein sampling in a patient with primary hyperaldosteronism and normal adrenal imaging?
1 Answer available
How do you counsel patients on the likelihood of resolution of their hypertension post adrenalectomy for primary hyperaldosteronism?
Zarnegar R, et al. The aldsoteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma.  PMI...
1 Answer available
How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?
ESPRIT Trial
1 Answer available
How does contralateral suppression of more than 50% with cosyntropin during adrenal venous sampling influence your decision to recommend adrenalectomy in patients with primary aldosteronism?
Okubo et al., PMID 38442744
1 Answer available
In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?
1 Answer available
Which medications do you deem necessary to stop prior to measuring plasma renin and plasma aldosterone when evaluating a patient for possible primary aldosteronism?
1 Answer available
What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?
1 Answer available
What is your preferred method for confirming the diagnosis of primary aldosteronism in a patient with an elevated plasma aldosterone to renin ratio?
1 Answer available


Papers discussed in this category

The Journal of clinical endocrinology and metabolism, 2016-05
The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.
Lancet (London, England), 2024 Jun 27
Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial.
The Journal of surgical research, 2012 Aug 15
Persistent hypertension after adrenalectomy for an aldosterone-producing adenoma: weight as a critical prognostic factor for aldosterone's lasting effect on the cardiac and vascular systems.
N Engl J Med, 2015 Nov 09
A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
Diabetes care, 2025 Jan 01
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2025.
The New England journal of medicine, 2024 Nov 16
Intensive Blood-Pressure Control in Patients with Type 2 Diabetes.

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