Investigations in endocrinology

Investigating primary aldosteronism

RAFID AL-AMERI, Bernard Champion



There are clear criteria for screening and diagnosis of primary aldosteronism. Initial screening includes measurement of the aldosterone-to-renin ratio and electrolytes.

Article Extract

Primary aldosteronism (PA) is characterised by autonomous hypersecretion of aldosterone manifesting as hypertension and associated vascular comorbidities, sodium retention and possible hypokalaemia. Often inadvertently misdiagnosed as primary hypertension, PA is the most common correctable cause of secondary hypertension. Recent reports indicate the prevalence of PA in people with hypertension may be more than 10%.1,2 Before 1991, PA was regarded as a rare cause of secondary hypertension (<1%). In recent decades, greater awareness and screening has contributed to rising recognition; however, prevalence data can vary widely and despite clear screening guidelines, there is still significant under-recognition both locally and globally of this important disorder.1,3-7

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