The 2020 Italian Society of Arterial Hypertension (SIIA) Practical Guidelines for the Management of Primary Aldosteronism

Background And Aim: Considering the amount of novel knowledge generated in the last five years, a team of experienced hypertensionlogists was assembled to furnish updated clinical practice guidelines for the management of primary aldosteronism.

Methods: To identify the most relevant studies, the authors utilized a systematic literature review in international databases by applying the PICO strategy, and then they were required to make use of only those meeting predefined quality criteria. For studies of diagnostic tests, only those that fulfilled the Standards for Reporting of Diagnostic Accuracy recommendations were considered.

Results: Each section was jointly prepared by at least two co-authors, who provided Class of Recommendation and Level of Evidence following the American Heart Association methodology. The guidelines were sponsored by the Italian Society of Arterial Hypertension and underwent two rounds of revision, eventually reexamined by an External Committee. They were presented and thoroughly discussed in two face-to-face meetings with all co-authors and then presented on occasion of the 36th Italian Society of Arterial Hypertension meeting in order to gather further feedbacks by all members. The text amended according to these feedbacks was subjected to a further peer review.

Conclusions: After this process, substantial updated information was generated, which could simplify the diagnosis of primary aldosteronism and assist practicing physicians in optimizing treatment and follow-up of patients with one of the most common curable causes of arterial hypertension.

Citing Articles

Occurrence of Metabolic Disorders in Bilateral Primary Aldosteronism Compared to Unilateral Primary Aldosteronism.

Grasselli C, Baldini M, Salvi L, Vestita G, Zizzo M, Felaco D Diseases. 2025; 13(2).

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Shifting paradigms in primary aldosteronism: reconsideration of screening strategy via integrating pathophysiological insights.

Kitamoto T, Ruike Y, Koide H, Inoue K, Maezawa Y, Omura M Front Endocrinol (Lausanne). 2025; 15:1372683.

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The application value of ipsilateral superselective adrenal arteriography and adrenal venography in patients with primary aldosteronism undergoing adrenal artery embolization.

Liu S, Wang X, Wang P Hypertens Res. 2025; .

PMID: 39849050 DOI: 10.1038/s41440-025-02126-x.

Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications.

Dong Z, Song X, Jia M, Chen J, Zhang Y, Yu H Curr Hypertens Rep. 2024; 27(1):4.

PMID: 39680249 DOI: 10.1007/s11906-024-01319-y.

Predicting the resolution of hypertension following adrenalectomy in primary aldosteronism: Controversies and unresolved issues a narrative review.

Marzano L Langenbecks Arch Surg. 2024; 409(1):295.

PMID: 39354235 DOI: 10.1007/s00423-024-03486-7.

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