Primary Aldosteronism

Primary aldosteronism accounts for a substantial share of hypertension and resistant hypertension. Primary aldosteronism is caused by autonomous aldosterone secretion that is independent of renin. Unilateral primary aldosteronism is usually caused by an aldosterone-producing adenoma or nodule. Excess aldosterone in primary aldosteronism contributes to cardiovascular and kidney injury through inflammatory and fibrotic pathways. Patients with primary aldosteronism have higher cardiovascular and atrial fibrillation risk than matched patients with essential hypertension. Patients with primary aldosteronism have elevated risks of atrial fibrillation, myocardial infarction, stroke, and chronic kidney disease even when blood pressure is controlled. Primary aldosteronism is described as the most common cause of secondary hypertension. Primary aldosteronism is a common cause of secondary and resistant hypertension that is often underdiagnosed.