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“Most patients either have bilateral adrenal hyperplasia or normal-appearing adrenal glands on imaging and are therefore not candidates for surgery. These patients are managed medically with a mineralocorticoid receptor antagonist (MRA), such as spironolactone and eplerenone, and other antihypertensive agents.”
“People with primary aldosteronism face a higher risk of cardiovascular disease than those with primary hypertension. With a low-cost blood test, we could identify more people who have primary aldosteronism and ensure they receive the proper treatment for the condition.”
“Primary aldosteronism is the most common endocrine cause of secondary hypertension, with an estimated prevalence of up to 15% of individuals with hypertension seen in the primary care setting. Despite this finding, primary aldosteronism remains underdiagnosed, in part due to limited screening in routine clinical practice.”
Expands primary aldosteronism screening to all hypertensive patients; extends prior guidelines and supports earlier targeted therapy to reduce underdiagnosis.
The new guideline agrees with growing evidence that primary aldosteronism is common, often missed, and treatable.
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Sureshkumar et al. (2026) conducted a review in Primary aldosteronism. 2025 Endocrine Society clinical practice guideline vs. 2016 guideline was evaluated. The 2025 Endocrine Society guideline update recommends universal screening for primary aldosteronism in all patients with hypertension, simplifying testing protocols and introducing renin-guided therapy.
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