The Pituitary and Idiopathic Hyperaldosteronism

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Abstract
IN the past, when the diagnosis of primary aldosteronism was suspected in patients who presented with hypertension, hypokalemia, and increased urinary aldosterone production, bilateral adrenocortical hyperplastic tissue was frequently found at surgery and removed without correction of high blood pressure. Presumably, some such patients had secondary hyperaldosteronism due to unrecognized hyperreninemic states. The subsequent development of techniques to assess renin levels made it easy to distinguish between cases of primary and secondary aldosteronism. Yet, a small number of patients with primary aldosteronism and bilateral adrenal macronodular or micronodular hyperplasia were still not cured by subtotal or total adrenalectomy.1 Such patients . . .