Primary aldosteronism: Diagnosis and treatment

William Francis Young, M. J. Hogan, G. G. Klee, C. S. Grant, J. A. Van Heerden

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The syndrome of primary aldosteronism produces few signs or symptoms. The diagnosis should be suspected when either spontaneous hypokalamia or easily provoked hypokalemia is found in a patient with hypertension. Hypokalemia in association with inappropriate kaliuresis, low plasma renin activity, and a high plasma aldosterone concentration/plasma renin activity ratio are the findings on initial screening tests that should suggest primary aldosteronism. The diagnosis must be confirmed by demonstrating nonsuppressible aldosterone excretion in conjunction with normal cortisol excretion. The choice of therapy is based on distinguishing unilateral from bilateral adrenal disease. With a unilateral adrenal adenoma, surgical removal reverses the hypokalemia and frequently cures the hypertension. In most patients with bilateral adrenal hyperplasia who are treated surgically, however, hpyertension persists; thus, the initial treatment in these patients should be pharmacologic.

Original languageEnglish (US)
Pages (from-to)96-110
Number of pages15
JournalMayo Clinic Proceedings
Issue number1
StatePublished - 1990

ASJC Scopus subject areas

  • Medicine(all)

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    Young, W. F., Hogan, M. J., Klee, G. G., Grant, C. S., & Van Heerden, J. A. (1990). Primary aldosteronism: Diagnosis and treatment. Mayo Clinic Proceedings, 65(1), 96-110.