[Which screening tests should be chosen in 1994 in the cascade of primary hyperaldosteronism (Conn's syndrome)? Apropos of 3 personnel cases].

On the occasion of three cases of primary hyperaldosteronism the author expresses disapproval of the recently published recommendation of a general screening for aldosterone, plasma renin activity and their respective quotient in all hypertensive patients. Compared with the rareness of the disease, this screening seems extremely expensive and mostly useless. Even in view of the possibility of delaying diagnosis of extremely rare cases of normokalemic primary hyperaldosteronism by three to five years--an occurrence without negative consequences--the author recommends as a first step to follow clinical parameters by repeated determination of potassium and to engage highly specific and expensive tests not before strong suspicion for hyperaldosteronism arises. In 1994 costs of public medicine have increased to intolerable levels; therefore the consideration of a price/quality ratio is mandatory.