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Diagnosis of primary aldosteronism

William F Young, Jr, MD, MSc
Section Editors
André Lacroix, MD
George L Bakris, MD
Deputy Editor
Kathryn A Martin, MD


Nonsuppressible (primary) hypersecretion of aldosterone is an underdiagnosed cause of hypertension. The classic presenting signs of primary aldosteronism are hypertension and hypokalemia, but potassium levels are frequently normal in modern-day series of primary aldosteronism. The most common subtypes of primary aldosteronism are:

Aldosterone-producing adenomas (APAs)

Bilateral idiopathic hyperaldosteronism (IHA; bilateral adrenal hyperplasia)

Less common forms include:

Familial hyperaldosteronism type I (glucocorticoid-remediable aldosteronism [GRA]), type II (the familial occurrence of APA or bilateral idiopathic hyperplasia or both), and type III (associated with the germline mutation in the KCNJ5 potassium channel) (see "Familial hyperaldosteronism")

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Literature review current through: Dec 2017. | This topic last updated: Jan 02, 2018.
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