According to the Endocrine Society guidelines of 2016,3 the following patient types should be screened for primary aldosteronism (PA): patients with resistant hypertension and patients who have hypertension with other conditions or family history.
Resistant hypertension (defined as any of the following)
- Blood pressure (BP) >150/100 mmHg on 3 measurements on different days
- BP >140/90 mmHg resistant to 3 conventional hypotensive drugs (including a diuretic)
- BP <140/90 mmHg) on at least 4 antihypertensive drugs
Hypertension with any of the following
- Adrenal incidentaloma
- Sleep apnea
- Family history of early onset hypertension or cerebrovascular accident at a <40 years of age
- First-degree relative with PA
- Spontaneous or diuretic-induced hypokalemia