Publications by authors named "L AMAR"
Background: Primary aldosteronism can be treated medically but there is no standardised method to evaluate treatment outcomes. We aimed to develop criteria for assessing the outcomes of targeted medical treatment of primary aldosteronism, analyse outcomes across an international cohort, and identify factors associated with a complete treatment response.
Methods: An international panel of 31 primary aldosteronism experts used the Delphi method to reach consensus on the definition of complete, partial, or absent biochemical and clinical outcomes of medical treatment of primary aldosteronism.
Aldosterone synthase inhibitors: a potential revival for treatment of renal and cardiovascular diseases.
J Clin Endocrinol Metab
December 2024
Inappropriate aldosterone excess plays a key role in the pathophysiology of various cardiovascular, endocrine and renal diseases. Mineralocorticoid receptor (MR) antagonists (MRAs) such as spironolactone block of the harmful effects of aldosterone and are recommended treatment in these various conditions. However, the sexual adverse effects of spironolactone due to its lack of specificity for the MR and the risk of hyperkalemia in patients with decreased renal function, limit its use.
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- This study aimed to improve the identification of malignancy risk and genetic status in patients with primary paraganglioma or pheochromocytoma (PPGL) by assessing various biomarkers.
- Conducted over four years with 231 patients, the study found that tumor analysis was better than germline testing for determining genetic status, with specific biomarkers like plasma succinate levels and miR-483-5p showing promise in predicting metastasis.
- The combination of biomarkers, such as SDHB immunostaining and TERT promoter methylation, significantly enhanced the predictive accuracy for both SDHx genetic status and metastatic potential.
Several high-quality, randomized, sham-controlled trials have provided evidence supporting the efficacy and safety of radiofrequency, ultrasound and alcohol catheter-based renal denervation (RDN) for reducing blood pressure (BP). A French clinical consensus document has therefore been developed to propose guidance for the appropriate use of RDN in the management of hypertension along with a dedicated care pathway and management strategy. The French experts group concluded that RDN can serve as an adjunct therapy for patients with confirmed uncontrolled, resistant essential hypertension despite treatment with≥3 antihypertensive drugs, including a long-acting calcium channel blocker, a renin-angiotensin system blocker and a thiazide/thiazide-like diuretic at maximally tolerated doses.
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- - The study focused on understanding how common secondary hypertension (2HTN) is in young adults aged 18 to 40, finding that nearly 30% of patients had 2HTN.
- - The most common causes of 2HTN were identified as primary aldosteronism, renovascular hypertension, and kidney diseases, with certain factors like being female and having a lower BMI linked to a higher prevalence.
- - Based on their findings, the researchers recommend that all young adults with hypertension should be screened for secondary causes, as there is a significant risk present regardless of age or blood pressure levels.