Testing for Primary Aldosteronism in Patients with Treatment-Resistant Hypertension

Approximately one in five hypertensive patients has treatment-resistant hypertension — defined as inadequately controlled blood pressure (BP) with 3 antihypertensive agents or requiring ≥4 antihypertensive agents to achieve BP control. Primary aldosteronism occurs commonly (≈22% prevalence) in patients with treatment-resistant hypertension (NEJM JW Gen Med Jul 1 2020 and Ann Intern Med 2020; 173:10), and guidelines recommend testing for and treating primary aldosteronism in this population (NEJM JW Gen Med Dec 15 2017 and J Am Coll Cardiol 2018; 71:127). Investigators analyzed a retrospective cohort of 270,000 U.S. veterans with treatment-resistant hypertension to determine the rate of testing for primary aldosteronism and related mineraloc…