Quality of Life of Primary Aldosteronism Patients by Mineralocorticoid Receptor Antagonists

Abstract

Context: Although primary aldosteronism (PA) reduces quality of life (QOL), there have been no reports on whether treatment with a mineralocorticoid receptor antagonist (MRA) improves QOL in Japanese PA patients. Objective: Using the 36-Item Short-Form Health Survey (SF-36), we compared the QOL of PA patients before and after treatment and evaluated whether the effectiveness of MRAs differs by sex and serum potassium level. Methods: In 50 patients diagnosed with PA (with or without hypokalemia) and treated with an MRA, the SF-36 scores, blood pressure, and clinical features were assessed before, and 3 and 6 months after treatment. Separate analyses were also conducted for males and females. Results: The normative mean SF-36 score of the healthy subjects was 50. The pretreatment Role-Physical (RP) (46.7 ±} 1.8, P = .019), General Health (47.1 ±} 1.3, P = .042), and Role-Emotional (47.2 ±} 1.7, P = .045) SF-36 subscale scores of all PA patients were significantly lower than those of healthy subjects but were improved by MRA treatment. Females with PA had a lower RP score (45.1 ±} 2.2, P = .008), which was not improved by MRA treatment (46.1 ±} 2.4, P = .036). In addition, PA patients with hypokalemia had a lower Mental Health SF-36 subscale score (43.2 ±} 4.4, P = .041), which was improved by treatment with an MRA. Conclusion: MRAs improved the QOL of Japanese PA patients, but female PA patients may be more resistant to MRAs.