Clarification of hypertension – Diagnosis of primary hyperaldosteronism

Primary hyperaldosteronism (PH) is the most common cause of secondary hypertension. Apart from hypertension, hypokalaemia was hitherto considered to be the classical cardinal symptom. Its presence was therefore also usually a prerequisite for further diagnostic clarification in respect of PH. However, numerous new studies in normokalaemic hypertension patients now show that serum potassium levels are within the reference range in approximately 90% of PH patients. On the basis of the new data, which were obtained by determining the aldosterone/renin ratio (ARR), the frequency of PH in hypertensives – 5-13% – is much higher than previously suspected (0.1-1%) [1, 2, 3, 19].