Authors: Saba Samad Memon et al. Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension, characterized by renin-independent aldosterone overproduction. Previously considered rare and primarily linked to hypokalemia, newer evidence reveals a higher prevalence—ranging from 5–15% in hypertensive patients, including those with normal potassium levels. Indian studies also report significant rates, particularly in young hypertensives.
Despite its high prevalence and associated cardiovascular risks, PA remains vastly underdiagnosed due to low screening rates. The Endocrine Society (ES) recommends screening high-risk patients using the plasma aldosterone-renin ratio (ARR), with confirmatory tests for positive results. Experts now advocate broader screening, even irrespective of medication status, and emphasize interpreting aldosterone and renin levels…
