[Mineralocorticoid hypertension. A new form of secondary hypertension?]

There is a group of genetic alterations that are phenotypically related to mineralocorticoid hypertension. They include, among others, some forms of primary hyperaldosteronism and of hyporeninemic aldosteronism that can be specifically treated, thus becoming secondary forms of hypertension. These could account for 10 to 15% of cases of essential hypertension, but more studies are required to accept these figures. The screening for these forms of hypertension should be done measuring aldosterone levels and plasma renin activity. An aldosterone/plasma renin activity ratio over 25 should lead to the suspicion of the disease. However, the cost effectiveness of the widespread measurement of these parameters would be very low. Therefore it is mandatory to determine the epidemiological features of these diseases to perform a selective screening among subjects with essential hypertension.