Trends in the prevalence of primary aldosteronism, aldosterone-producing adenomas, and surgically correctable aldosterone-dependent hypertension

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Abstract
Although primary aldosteronism (PA) has long been considered a rare cause of hypertension, recent reports suggest that the prevalence of PA among hypertensive patients may exceed 10% [1,2]. An actual increase in the true prevalence of PA is unlikely [3,4], but diagnostic advances may result in a more frequent and effective screening for the condition. Screening for PA is no longer limited to patients with hypokalaemia [1–9]. Using the aldosterone to renin ratio (ARR) is a more convenient screening test than separate determinations of plasma renin activity (PRA) and urinary aldosterone excretion [1–6,8,10,11] and, according to some [1–6,10] but not all [11–14] reports, is less influenced by antihypertensive medication.