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Primary aldosteronism: the case for screening

Nature Clinical Practice Nephrology volume 3, pages 582–583 (2007)Cite this article

Our clinical viewpoint has evolved from our own approach to patient care. Each patient treated at the Greenslopes Hypertension Unit in Brisbane, Australia, is regarded as a unique individual, who is encouraged to share our knowledge on blood pressure physiology and the 'white coat effect', and to use home blood pressure measurement to avoid overmedication. Logic dictates that each individual should be screened for specifically treatable causes of hypertension, including primary aldosteronism (PA), which can cause drug-resistant hypertension with complications.

Early, normokalemic forms of PA that mimicked 'essential' hypertension were responsible for the now-recognized1 initial underestimate of this condition's incidence. Recent evidence2 indicates that inappropriately high plasma aldosterone levels (as identified by suppressed plasma renin levels) have an even wider role in the development of hypertension than Jerome Conn originally thought. Diagnosing PA and treating this condition, by removing an adrenal gland (if unilateral) or with partial aldosterone blockade (if unilateral or bilateral), is good for the patient. Recent studies have shown that untreated aldosterone excess has serious cardiovascular effects.3

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Authors and Affiliations

  1. RD Gordon and M Stowasser are Co-Directors of the Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia.,

    Richard D Gordon & Michael Stowasser

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  1. Richard D Gordon
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  2. Michael Stowasser
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Correspondence to Michael Stowasser.

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The authors declare no competing financial interests.

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Gordon, R., Stowasser, M. Primary aldosteronism: the case for screening. Nat Rev Nephrol 3, 582–583 (2007). https://doi.org/10.1038/ncpneph0626

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