Annals On Call Podcast Diagnosing Primary Aldosteronism
Jul 14, 2025
Jordana Cohen, a nephrologist and clinical researcher at Penn, dives into the underutilization of screening for primary aldosteronism. She reveals that less than 2% of eligible individuals are tested and stresses the need for better diagnostic strategies. The conversation critiques current confirmatory testing methods and champions new approaches. Additionally, they discuss the rising use of mineralocorticoid blockers in hypertension treatment and compare options for resistant hypertension, highlighting effective alternatives like ameloride.
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Confirmatory Tests Perform Poorly
- Confirmatory tests for primary aldosteronism perform poorly and may misclassify patients.
- Treatment-based outcomes better define true disease presence than confirmatory testing.
Aldosterone Causes Major Organ Damage
- Primary aldosteronism probably causes much hypertensive kidney disease and heart problems.
- Early diagnosis and treatment can prevent serious organ damage and improve long-term outcomes.
Screen All Hypertensive Patients
- Screen everyone with hypertension for primary aldosteronism due to significant underdiagnosis.
- Use renin and aldosterone tests without stopping medications and treat based on results without mandatory confirmatory testing.