{"id":"0b3b4cad40fc","type":"article","url":"https://hartvaat.nl/2026/02/13/nieuwe-medicamenteuze-therapieen-bij-primair-aldosteronisme/","title":"Nieuwe medicamenteuze therapieën bij primair aldosteronisme","title_en":"Emerging Medical Therapies for Primary Aldosteronism","category":"hypertensie","category_label":"Hypertensie","professions":["apotheker","cardioloog","internist"],"tags":["aldosteronsynthaseremmers","baxdrostat","bloeddrukbehandeling","cardiorenal-behandelstrategie","eplerenon","lorundrostat","mra-aldosteronantagonisten","resistente-hypertensie","resistente-hypertensie-aldosteronremmers","sacubitril-valsartan","spironolacton"],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26229","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26229","authors":["Peeradon Vibhatavata"],"significance":7,"published":"2026-02-13","source_date":"2026-02-13","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-diabetes/"],"congress":"","summary_en":"This review discussed emerging medical therapies for primary aldosteronism beyond traditional MRAs, including aldosterone synthase inhibitors and other novel agents targeting upstream aldosterone production.","created":"2026-07-03T10:25:21Z","updated":"2026-07-03T13:24:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De medicamenteuze behandeling van primair aldosteronisme steunt al decennia op mineralocorticoïdreceptorantagonisten. Dit overzicht bespreekt opkomende therapieën die de aldosteronproductie zelf aanpakken in plaats van alleen de downstream-signalering te blokkeren.","abstract_original":"Hypertension, Volume 83, Issue 5, Page e26229, May 1, 2026. Medical therapy for primary aldosteronism has been stagnant for decades, relying on mineralocorticoid receptor antagonists, which block downstream signaling of aldosterone rather than aldosterone production. This approach typically leads to reactive elevation of aldosterone production, and possible implications of its nongenomic effects. In addition, steroidal mineralocorticoid receptor antagonist use is limited by cross-reactivity with other nuclear receptors and concern for hyperkalemia, particularly in kidney insufficiency. These limitations have propelled a rising interest in therapies that suppress aldosterone production. Aldosterone synthase inhibitors directly target aldosterone synthase overexpression and aldosterone excess. This review presents the evolving landscape of primary aldosteronism therapies, including emerging aldosterone synthase inhibitors and nonsteroidal mineralocorticoid receptor antagonists, and it pr"}