Hazards of Long-Term Dexamethasone Treatment in Primary Aldosteronism

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Abstract
To the Editor: Ganguly et al. reported in the October 22 issue1 on an anomalous postural aldosterone response in glucocorticoid-suppressible hyperaldosteronism (GSH). Since the absence of this response is also an indication of adenomatous primary aldosteronism (APA),2 Ganguly et al. advocate treatment with dexamethasone for four to six weeks if a postural decline has been demonstrated in a patient with primary aldosteronism. However, although glucucorticoids readily reduce blood pressure and aldosterone excretion to normal in GSH, little is known about the effects of long-term dexamethasone treatment in patients with APA. We report below that not only may blood pressure rise . . .