Primary aldosteronism.

Primary aldosteronism is the most common form of secondary hypertension. Case detection is based on an abnormal plasma aldosterone:plasma renin activity ratio and the diagnosis must be confirmed with an aldosterone suppression test. Subtype differentiation should be performed using adrenal venous sampling. Approximately 50% of patients with primary aldosteronism will have a unilateral aldosterone-producing adenoma; laparoscopic adrenalectomy results in cure of hypertension in 60% and improvement in blood pressure control in the remainder.