Hypertension Clinical Trial
Official title:
Adrenal Artery Ablation for Primary Aldosteronism:A Randomized, Parallel, Active-controlled Clinical Trial to Evaluate the Efficacy and Safety of Adrenal Artery Ablation(AAA)in the Treatment of Primary Aldosteronism
Primary aldosteronism (PA) is one of the most common causes of endocrine and resistant
hypertension. Current studies have shown that the activation of the
renin-angiotensin-aldosterone system (RAAS) and the increased sympathetic nerve activity in
the central or local tissue are the key mechanisms of high blood pressure and its organ
damages.
The classical method for diagnosis of primary aldosteronism depends on the detection of
peripheral venous blood aldosterone level, which is incapable of accurate positioning
diagnosis. On the other hand, the current guidelines recommend that surgery and aldosterone
receptor inhibitors were the only treatment for primary aldosteronism. However, only about
35% of aldosterone tumors and a small part of unilateral adrenal hyperplasia can be treated
by surgery. More than 60% of idiopathic aldosteronism and bilateral adrenal hyperplasia need
long-term drug therapy. However, long-term aldosterone inhibitor treatment may also cause
hyperkalemia, male breast hyperplasia, female hirsutism and other adverse reactions.
Therefore, the investigators proposed that endovascular chemical partial ablation of the
adrenal gland can lower the aldosterone level, reduce the blood pressure and recover the
potassium metabolism balance. In order to confirm the above effects, the investigators
conduct an open, prospective, positive controlled study in patients with primary
aldosteronism patients (including aldosterone, idiopathic aldosteronism and adrenal
hyperplasia). The effects on blood pressure, blood electrolytes, adrenal hormones, metabolic
indexes, target organ damages were observed to explore the efficacy and safety of the
endovascular ablation of the adrenal gland in the treatment of primary aldosteronism.
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