Efficacy of Spironolactone Combined With Antihypertensive Drugs in Patients With Primary Aldosteronism

Inclusion Criteria: 1. Male or female, aged 30\~65 years. 2. PA patients with positive screening tests and saline suppression tests, and with AVS to determine lateralization. These patients have hypertension defined as office blood pressure ≥ 140/90 mmHg, or 24-hour ambulatory blood pressure showing average ≥ 130/80 mmHg, daytime blood pressure ≥ 135/85 mmHg, or nighttime blood pressure ≥ 120/70 mmHg. 3. Patients with unilateral aldosterone-producing adenoma who decline surgery, or patients with non-adenoma, unilateral PA confirmed by AVS and meeting the above PA-related hypertension criteria. 4. Provision of written informed consent to participate in the study. Exclusion Criteria: 1. Hyperkalemia. 2. Renal impairment or have history of renal disease: serum creatinine \> 1.5 × upper limit of normal (ULN), dialysis, or nephrotic syndrome. 3. Other confirmed secondary hypertension: pheochromocytoma, Cushing's syndrome, thyroid disorders, parathyroid disorders, acromegaly, renovascular disease, aortic disorders, chronic alcoholism, or drug dependence, etc. 4. Adrenal insufficiency. 5. Heart failure with NYHA class II-IV or stroke. 6. Acute infection, malignancy, severe arrhythmia, psychiatric disorders, or drug/alcohol abuse. 7. Significant hepatic dysfunction or have history of liver disease: AST or ALT \> 2 × ULN, cirrhosis, hepatic encephalopathy, esophageal varices or portosystemic shunt. 8. Pregnancy or lactation. 9. Participation in another clinical trial within the past 3 months. 10. Inability to complete follow-up. 11. Refusal to provide informed consent.