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Some studies have suggested that primary aldosteronism is a more common secondary cause of hypertension than clinicians generally believe. In this study from Emory University, researchers identified 100 consecutive diabetic patients (mean age, 59) with resistant hypertension — defined as blood pressure >140/90 mm Hg while taking at least three antihypertensive drugs — and screened them for primary aldosteronism. Mean duration of hypertension was 16 years, and 93% of patients were black.
Thirty-four patients had an elevated aldosterone-to-renin ratio (defined here as >30) and then underwent confirmatory testing (salt loading followed by aldosterone measurements), resulting in a final diagnosis of primary aldosteronism in 14 patients. Informat…