Primary Aldosteronism: what consensus for the diagnosis

Primary Aldosteronism (PA) is characterized by inappropriate aldosterone production partially autonomous of the renin-angiotensin system. Since the ARR ratio was introduced a much higher prevalence of this disease is recognized. PA could be the most common identifiable, specifically treatable and potentially curable form of hypertension so the need of a clinical practice guideline on primary aldosteronism becomes mandatory. Recently the Endocrine Society USA published clinical practice guidelines for the diagnosis and treatment of patients with primary hyperaldosteronism. Systematic reviews of available evidence were used to formulate the key treatment and prevention recommendations. Actually the Endocrine Society consensus is the most used guidelines in diagnosis and treatment of hyperaldosteronism. However, there remains a few unresolved issues, which unfortunately require more of a detour guide and cannot be easily addressed by a straight forward guideline.