Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline

This clinical practice guideline recommends screening all adults with hypertension for primary aldosteronism (PA) using aldosterone and renin measurements. The guideline also provides detailed recommendations for confirmatory testing, medical and surgical treatment, and ongoing monitoring, emphasizing a personalized approach based on disease severity and patient characteristics. While based on the best available evidence, the guideline acknowledges limitations due to the limited number of randomized controlled trials in many areas of PA management.

Some panel members disclosed financial relationships with pharmaceutical companies that manufacture medications relevant to PA treatment. These conflicts were managed through disclosure and, where necessary, recusal from voting on specific questions.

This guideline offers a significant advancement in PA care by recommending universal screening for all hypertensive patients. This has the potential to improve detection and treatment rates, ultimately benefiting patients through better blood pressure control and reduced cardiovascular risk. The reliance on observational studies and expert opinion, due to limited RCT data, is a notable limitation but understandable given the current research landscape. The guideline acknowledges implementation challenges and offers pragmatic solutions, strengthening its practical value. The management of potential conflicts of interest adds further credibility to the recommendations.