The Prevalence of Primary Aldosteronism in Screening Populations: Is Hypokalaemia Important?

Dear Editor, We read with great interest the article by Asbach et al., ‘Prevalence of Primary Aldosteronism in Newly Diagnosed Hypertensive Patients in Primary Care’, published in Experimental and Clinical Endocrinology & Diabetes [1]. The authors reported that of 200 patients with newly-diagnosed hypertension in 27 primary care centres, 42 (21.0 %) had an elevated aldosterone-to-renin ratio (ARR), of which 11/33 (33.3 %) were subsequently confirmed to have primary aldosteronism (PA). This gave a 5.5 % prevalence of PA in people with newly-diagnosed hypertension. Curiously, none of the patients with confirmed PA were hypokalaemic at screening, and hypokalaemia prevalence did not differ at screening between those with normal or pathological ARR.