4.7 Review

Primary Aldosteronism: Where Are We Now? Where to From Here?

Journal

HYPERTENSION
Volume 79, Issue 4, Pages 726-735

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.121.18761

Keywords

aldosterone; hypertension; prevalence; renin; sodium dietary

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Primary aldosteronism, the most common secondary form of hypertension, may have a higher prevalence than previously estimated. The screening rate for primary aldosteronism is currently low, and more research is needed to explore screening and treatment methods.
Primary aldosteronism, the most common secondary form of hypertension, is thought to be present in approximate to 5% to 10% of hypertensive adults. However, recent studies indicate that its prevalence may be at least 3-fold higher based on the identification of renin-independent (autonomous) aldosterone production that is not suppressible with dietary sodium loading in a large fraction of adults with primary hypertension. Currently, the screening rate for primary aldosteronism in adults with primary hypertension is <1%. This review summarizes current thinking about primary aldosteronism from the standpoint of 3 key questions: Where are we now? Where to from here? So how do we get there?

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