A GP guide to primary aldosteronism

Increased awareness and active screening for this condition in the primary care setting are key to timely diagnosis and improved patient outcomes

Need to know:

  • Primary aldosteronism is a common secondary cause of hypertension.
  • Untreated primary aldosteronism is associated with worse cardiovascular outcomes than blood pressure-matched essential hypertension.
  • The best screening test for primary aldosteronism is an aldosterone to renin ratio, measured in the morning around two hours after getting up.
  • Antihypertensive medications that interfere with the aldosterone to renin ratio should ideally be stopped or switched to non-interfering medications before testing.
  • There are targeted and highly effective treatments for primary aldosteronism in the form of mineralocorticoid receptor antagonists, such as spironolactone, or surgical resection of aldosterone-producing adrenal adenoma.

Hypertension is the most common diagnosis made in Australian general practice and is a leading risk factor for chronic disease.1