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Guideline-recommended screening for primary aldosteronism in patients with resistant hypertension usually is accomplished by measuring serum aldosterone-renin ratio (ARR); however, screening rates are very low, and ARR might have low sensitivity for disease detection (J Clin Endocrinol Metab 2016; 101:1889). Using a cross-sectional study design, investigators evaluated more than 1000 patients from four geographically diverse U.S. sites. All participants underwent an oral sodium-load protocol at least 2 weeks after withdrawal of all antihypertensive medications for most patients (some medications were continued in patients with resistant hypertension at one site). Two thirds of patients had adequate suppression of renin to assess renin-indep…