Main
stroke, heart failure, Hypertension, treatment-resistant, deaths, hypertension
PRIMARY ALDOSTERONISM, HYPERTENSION, STROKE, RENAL FAILURE, PRIMARY HYPERALDOSTERONISM, HYPERTENSION, HEART FAILURE, CORONARY HEART DISEASE
Hypertension is a major cause of deaths from stroke, coronary heart disease, heart failure and renal failure. The most common single cause of hypertension is primary aldosteronism (PA), accounting for 5–14% of all cases and 20–25% of treatment-resistant hypertensionDespite the prevalence and penalty of PA, currently, fewer than 1% of patients are identified and fully investigatedMolecular imaging has the potential to increase the number of patients with PA who can be fully investigated. The current criterion standard used to distinguish patients with APA from those with IHA is adrenal vein sampling (AVS)—an invasive, technically demanding procedure with restricted availability. Metomidate—a methyl analog of the anesthetic agent etomidate—is a potent inhibitor of CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase), the final two enzymes involved in cortisol and aldosterone synthesis, respectively. Metomidate can be The primary aim of this study, which we have termed MATCH (Is Metomidate superior to AVS in predicting ouTComes from adrenalectomy in primary Hyperaldosteronism), was to compare the accuracy of AVS and MTO in predicting the outcome from adrenalectomy in patients with PA (Fig. 