Approach to a patient with suspected primary aldosteronism.

A typical case of a patient with suspected mineralocorticoid hypertension is discussed. The presentation follows sequential steps through the diagnostic evaluation and treatment of primary aldosteronism. The diagnostic approach can be classified into three phases: screening tests, confirmatory tests, and subtype differentiation studies. It is essential to follow the evaluation steps to elucidate the cause of primary aldosteronism, as this determines the appropriate treatment. Another lesson to learn is the need to critically appraise the value of any endocrine test, particularly if it is likely to influence the management strategy in an individual patient.