irreversible kidney damage,” which may require dialysis, says endocrinologist William Young Jr. of the Mayo Clinic. Although, Young treats about 250 primary aldosteronism patients a year he says it’s minuscule “compared to what’s going on out there.”
“I think if physicians realize how common this truly is,” he adds, “they would start to look for it more often.”
As a method of increasing detection, experts suggest removing a requirement that patients take a hiatus from blood pressure medications prior to screening, liberalizing cutoffs for a positive ARR result, and bypassing ARR for urine excretion tests, which are more reliable but cost more. Others have suggested wider prescribing of drugs to treat primary aldosteronism, even as a first-line hypertension therapy, according to UNDARK.
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Getting a screening and treatment
The Endocrine Society, a medical organization dedicated to the advancement of hormone science and public health, recommends that patients who exhibit the following red flags get a screening:
- Low potassium
- An adrenal mass that shows up on a scan
- Drug-resistant hypertension — defined as blood pressure that is uncontrolled despite taking three different kinds of antihypertensive medications at their maximally tolerated doses
- A family history of early-onset hypertension
- Stroke before age 40