Tatalaksana Farmakologi Hipertensi pada Hiperaldosteronisme Primer

I Gede Yasa Asmara

Abstract

Hipertensi secara umum menurut etiologinya dibagi menjadi primer dan sekunder. Hiperaldosteronisme primer merupakan salah satu penyebab hipertensi sekunder yang memiliki terapi spesifik dan sangat mungkin disembuhkan. Hiperaldosteronisme primer memiliki efek multiorgan antara lain penurunan sensitivitas insulin pada otot dan jaringan lemak, gangguan fungsi sistolik dan hipertrofi otot jantung, inflamasi ginjal dan aterosklerosis. Diagnosis melalui tiga tahapan yaitu skrining, tes konfirmasi dan analisis subtipe. Tatalaksana meliputi non-farmakologi, medikamentosa dan pembedahan. Obat golongan antagonis mineralokortikoid seperti spirolonakton dan eplerenon merupakan pilihan utama untuk hiperaldosteronisme primer.

Based on its etiology, hypertension can be subdivided into primary and secondary. Primary hyperaldosteronism is secondary hypertension with specific treatment and may be curable. The disease is associated with renal, metabolic, brain and cardiovascular complications. Primary hyperaldosteronism affects multi organs such as reduced insulin sensitivity on muscle and adipose tissue, systolic dysfunction, myocardial hypertrophy, inflammation in the kidney and atherosclerosis. Diagnosis of primary hyperaldosteronism consists of three steps i.e. case-finding, a confirmatory test, and subtype evaluation. The management comprises non-pharmacology, medication, and surgery. Mineralocorticoid antagonists such as spironolactone and eplerenone are the drug of choice for primary hyperaldosteronism.

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