When do you consider workup for hyperaldosteronism?

When do you consider workup for hyperaldosteronism?

Important situation in which hyperaldosteronism is suspected is when there is hypertension with hypokalemia. Hypertension with spontaneous as well as diuretic induced hypokalemia may be an indication of hyperaldosteronism. Another reason for workup is refractory hypertension in spite of three antihypertensive medications. Hypertensive patient having hypokalemia while on angiotensin converting enzyme inhibitors or angiotensin receptor blockers should also alert us.

Yet another group is hypertensives with adrenal masses detected on imaging studies. First degree relatives of patients with primary hyperaldosteronism need workup. Other potential situations are those with a family history of early onset hypertension or cerebrovascular accident before the age of 40 years. Patients with onset of hypertension before the age of 20 years are also potential candidates.