Primary aldosteronism: new approaches to diagnosis and management
Donald G. Vidt, MD
Alan Bakst, PharmD
Emmanuel L. Bravo, MDAddress reprint requests to E.L.B., Department of Cardiovascular Biology, The Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Primary aldosteronism remains a diagnostic challenge. Certain immunoassay techniques, simplified diagnostic testing, and the introduction of sensitive imaging techniques have facilitated the diagnosis, but obstacles that remain include a lack of optimal screening methods, low sensitivity and specificity of current diagnostic tests, and a growing number of etiological subgroups. A rational approach to the diagnosis of primary aldosteronism is described, as is the differentiation of the surgically correctable lesion (adenoma) from the other etiological subgroups.