Primary hyperaldosteronism due to adrenal microadenoma: a curable cause of refractory hypertension

Abstract

The robotic assay of renin mass permits rapid detection of patients in whom plasma renin is suppressed below the normal range. A suppressed plasma renin indicates abnormal Na+-retention, and--when not overcome by drugs such as angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers--may be the only clue to a curable adrenal adenoma. AVS is required to demonstrate lateralisation of aldosterone secretion, justifying adrenalectomy.