If you have high blood pressure (hypertension), you may have primary aldosteronism. While some advocate systematic screening, the current consensus is to prioritize testing with patients who have:
- Resistant hypertension:
- Those patients with sustained blood pressure above 150/100 mm Hg on each of three measurements obtained on different days, or
- Patients with hypertension (blood pressure >140/90 mm Hg) resistant to three conventional antihypertensive drugs (including a diuretic), or
- Patients with controlled hypertension (<140/90 mg Hg) on four or more blood pressure medications.
- Hypertension and spontaneous or diuretic-induced hypokalemia (i.e., low potassium).
- Hypertension and an adrenal “incidentaloma.” That is, if you have high blood pressure and when you had a CT scan for some other reason, you were told that there is a nodule or bump on one of your adrenal glands.
- Hypertension and sleep apnea. If you have high blood pressure and have been diagnosed with obstructive sleep apnea (OSA) or sleep apnea is highly suspected.
- Hypertension and a family history of early onset hypertension or stroke at a young age (<40 years). You should also consider getting tested if you are under 40 and have been diagnosed with high blood pressure even if you are unsure about your family history.
- Hypertension and a first degree relative with primary aldosteronism. If you have high blood pressure and someone in your immediate family has primary aldosteronism, you should be tested.