[1][2] Treatment is tailored to the specific cause and focuses on symptom control, blood pressure management, and avoidance of triggers.
[1][4][2] Adult patients present with clinical history of resistant hypertension despite typical medical therapy and lifestyle changes.
[1] Genetic disorders that lead to this condition include Liddle's syndrome, apparent mineralocorticoid excess (AME), and two types of congenital adrenal hyperplasia (CAH).
[3][9] Glycyrrhetinic acid in licorice inhibits the 11-β-HSD2 enzyme resulting in inappropriate stimulation of the mineralocorticoid receptor by cortisol leading to aldosterone-like effects.
General management focuses on countering the effects of excess mineralocorticoid activity to achieve adequate blood pressure control and avoid end-organ damage and cardiovascular mortality.
[4][10][2] In AME, the mineralocorticoid receptor-binding potassium-sparing diuretics (e.g. spironolactone or eplerenone) are used to limit aldosterone receptor activity.