Effects and Long-term Outcomes of Adrenal Artery Ablation Versus Spironolactone Treatment in Adults With Primary Aldosteronism and Hypertension

What this Trial Is About

Primary aldosteronism PA is a common cause of endocrine and resistant high blood pressure, involving overactivation of the renin-angiotensin-aldosterone system and increased nerve activity that damages organs. Current treatments include surgery and aldosterone receptor blockers, but surgery is limited to certain cases, and long-term medication with spironolactone can cause side effects. This study investigates the effects and safety of adrenal artery ablation compared with spironolactone in patients with PA, aiming to assess impacts on blood pressure and cardiovascular health. Participants will receive either adrenal artery ablation, which uses an endovascular injection of dehydrated alcohol to partially destroy adrenal tissue, or daily spironolactone doses ranging from 20 to 80 mg based on blood pressure control. The study is an open-label, non-randomized cohort design comparing these two treatment approaches over time. During the three-year study, researchers will monitor changes in office and 24-hour blood pressure, heart structure and function via echocardiography, and carotid artery thickness using ultrasound. They will also track major adverse cardiac events and safety outcomes. Participants will have regular assessments to evaluate treatment effects on cardiovascular risk and blood chemistry, with the goal to better understand long-term prognosis and treatment safety in PA patients.

Effects of Adrenal Artery Ablation and Spironolactone in Patients With Primary Aldosteronism