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Estimates of the prevalence of primary hyperaldosteronism among hypertensive patients have ranged from as high as 20% to as low as 1% in unselected patients.
Researchers determined the prevalence of primary hyperaldosteronism among 1616 consecutive patients who were seen at a Greek hypertension clinic during a 20-year period; all patients had resistant hypertension (uncontrolled on a diuretic and 2 other drugs, and confirmed by home or ambulatory measurements). Aldosterone-to-renin ratios (ARRs) and serum aldosterone levels were measured in all patients under controlled conditions; 338 patients in whom both measures were elevated underwent salt-loading suppression tests and 4-day fludrocortisone tests to confirm primary hyperaldosteronism. A…