Association of the primary aldosteronism severity classification with lateralization and treatment outcomes
Authors' conclusion
PASC-defined severity correlated with AVS-defined lateralization. Greater severity was associated with lower rates of complete clinical success/response despite preserved biochemical outcomes, supporting a severity-informed framework to complement AVS in PA management.
Study context
- Population
- Patients with primary aldosteronism (PA) who underwent adrenal venous sampling (AVS), 8 tertiary centres
- Participants
- 833 patients
- Exposure
- PA severity classification (PASC) severity: mild vs moderate vs severe
- Mildn = 52reference
- Moderaten = 563
- Severen = 218
- Outcome
- AVS-defined lateralization and treatment outcomes by PASO and PAMO criteria
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
AVS-defined lateralizing PA
P < 0.001
Observational data: associations, not effects.
Further findings
PAMO complete clinical response, bilateral PA treated medically — between Mild and Severe · PAMO clinical outcomes varied by severity
P = 0.005
- Primary Aldosteronism Surgical Outcome (PASO) clinical outcomes, unilateral PA treated surgically · between Mild and Severe · differed by severity across mild, moderate, severe
- P = 0.002
- PASO clinical outcomes, unilateral PA treated surgically — Complete clinical success, moderate
- 40.2%
- PASO clinical outcomes, unilateral PA treated surgically — Complete clinical success, severe
- 31.3%
- PASO clinical outcomes, unilateral PA treated surgically — Partial clinical success, severe (marked increase)
- 55.1%
- PASO biochemical outcomes, unilateral PA treated surgically · between Mild and Severe · similar across severity groups
- P = 0.389
- PAMO biochemical outcomes, bilateral PA treated medically · between Mild and Severe · comparable across severity groups
- P = 0.993
Original publication
Association of the primary aldosteronism severity classification with lateralization and treatment outcomes. J Clin Endocrinol Metab. Published 30 June 2026. doi:10.
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