[Primary hyperaldosteronism - screening, work-up, treatment]

Primary hyperaldosteronism is a common and treatable cause of secondary arterial hypertension. Case finding with the aldosterone-to-renin ratio is recommended in all patients with arterial hypertension. If the case finding test is positive, a confirmatory test should be performed, followed by imaging of the adrenal glands and adrenal vein sampling. Treatment depends on the cause. Laparoscopic adrenalectomy is the treatment of choice for unilateral secretion and medical therapy with mineral corticoid receptor antagonists for bilateral secretion.