Abstract
Primary aldosteronism is defined by autonomous aldosterone overproduction. Aldosterone producing adenoma and bilateral adrenal hyperplasia (idiopathic aldosteronism) are the most frequent subtypes of primary aldosteronism.
Primary aldosteronism is according to the current knowledge the most frequent form of secondary hypertension. The highest prevalence of primary aldosteronism can be awaited in patients with moderate to severe hypertension with, but also without hypokalemia.
Significantly increased cardiovascular risk in primary aldosteronism is caused not only by hypertension and hypokalemia, but also by direct effect of excess aldosterone, as the most important reasons why to screen for primary aldosteronism. Aldosterone/plasma renin activity ratio is the first screening test, followed by a confirmation test.
The differential diagnosis of the different subtypes of primary aldosteronism is more complicated and therefore performed in hypertension centers.