Endocrine Society

Hypertension: Primary aldosteronism screening encouraged in new guideline

July 21, 2025

All patients with hypertension should be screened for primary aldosteronism (PA), according to suggested guidance from the Endocrine Society. The update reflects increasing recognition of PA’s prevalence and its association with adverse cardiovascular and renal outcomes when left untreated. Early identification through a low-cost blood test enables targeted pharmacologic or surgical intervention, with the potential to significantly improve long-term prognosis.

The updated Clinical Practice Guideline, presented at the Endocrine Society’s 2025 annual meeting, suggests measuring aldosterone, renin, and potassium levels in all hypertensive patients—regardless of subtype or severity. This represents a departure from prior guidance, which limited screening to high-risk groups.

PA is estimated to affect 5–14% of patients in primary care and up to 30% in specialty settings. Despite this, the condition remains substantially underdiagnosed. While the authors acknowledge that broader screening may increase false positives, they emphasize that the clinical benefits of identifying and treating PA outweigh the risks, particularly given its strong links to stroke, atrial fibrillation, heart failure, and chronic kidney disease.

Source:

(2025, July 14). Endocrine Society. Endocrine Society guideline calls for increased screening for common cause of high blood pressure [Press release]. https://www.endocrine.org/news-and-advocacy/news-room/2025/endocrine-society-guideline-calls-for-increased-screening-for-common-cause-of-high-blood-pressure