Primary aldosteronism: the case against screening

Abstract

This, the first of two opposing Viewpoints, sets out the arguments against screening for primary aldosteronism. The author, from the Western General Hospital in Edinburgh, UK, asserts that the majority of individuals with a high aldosterone:renin ratio have a normal plasma aldosterone level. Physicians should, therefore, focus on optimizing the excretion of salt and water in hypertensive patients rather than on expensive tests to detect an aldosterone-secreting adenoma.