Clinical Research Directory

Inclusion Criteria: 1. Getting the written informed consent 2. The clear diagnosis of primary aldosteronism； 3. Combined with autonomous cortisol secretion, cortisol after 1mg dexamethasone suppression test (DST) ≥50 nmol/l； 4. Patients who are willing to undergo surgery； 5. Adrenal CT or MRI scan of the adrenal glands with nodule (≥1cm). Exclusion Criteria: 1. PA patients who meet the by-passing AVS criteria \[i.e., younger than 35 years old, spontaneous hypokalemia, adrenal CT indicated unilateral low-density adenoma (≥1cm), plasma aldosterone \>300pg/ml\]； 2. Suspicion of familial hyperaldosteronism or Liddle syndrome. \[i.e., age \<20 years, hypertension and hypokalemia, or with family history\]； 3. Suspicion of pheochromocytoma or adrenal carcinoma； 4. Patients with actively malignant tumor； 5. Patients who have adrenalectomy history； 6. Long-term use of glucocorticoids； 7. Patients who are allergic to contrast media and cannot tolerate AVS； 8. Pregnant or lactating women; with alcohol or drug abuse and mental disorders； 9. Congestive heart failure with New York Heart Association (NYHA) Functional Classification III or IV; History of serious cardiovascular or cerebrovascular disease (angina, myocardial infarction or stroke) in the past 3 months; Severe anemia (Hb\<60g/L); Serious liver dysfunction or chronic kidney disease aspartate aminotransferase (AST) or alanine transaminase (ALT) ≥3 times the upper limit of normal, or estimated glomerular filtration rate (eGFR) \<30 ml/min/1.73 m2); Systemic Inflammatory Response Syndrome (SIRS); Uncontrolled diabetes (FBG≥13.3 mmol/L); Obesity (BMI≥35 kg/m²); Untreated aneurysm; Other comorbidity potentially interfering with treatment； 10. Consider patients with bilateral cortisol hypersecretion such as PBMAH or PPNAD.