Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (805 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A condition caused by the overproduction of aldosterone. It is characterized by sodium retention and potassium excretion with resultant hypertension and hypokalemia.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Aldosteronism; Conn Syndrome; Syndrome, Conn; Conn's Syndrome; Conns Syndrome; Syndrome, Conn's; Primary Hyperaldosteronism; Hyperaldosteronism, Primary.
Where it fits in the MeSH classification
- Broader topics
- Adrenocortical Hyperfunction
- Narrower topics
- Bartter Syndrome
Related concepts
Research landscape
PubMed indexes 10,838 records tagged with the MeSH heading “Hyperaldosteronism” (counts retrieved 2026-11-04). 2,104 of them (19.4%) were published from 2020 onward, and the busiest period so far is through 1999 with 5,287 records.
Reviews account for 1,925 records (17.8%) and meta-analyses for 77. Randomized controlled trials number 55 (0.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 5,287 |
| 2000-2009 | 1,484 |
| 2010-2019 | 1,963 |
| 2020 onward | 2,104 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 1,925 | 17.8% |
| Meta-analyses | 77 | 0.7% |
| Randomized controlled trials | 55 | 0.5% |
Method: PubMed query "Hyperaldosteronism"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in metabolism and endocrine disease
Studies of diabetes, obesity and hormone disorders often follow blood tests such as glucose, HbA1c or hormone levels, which are stand-ins for outcomes that matter more, such as complications. Lifestyle and diet research is largely observational, and weight and diabetes trials can differ in how long people were followed. Nothing on this page is advice about medicines, insulin or diet; talk to a qualified clinician about your own situation. Check whether the outcome was a lab value or a clinical event, and the type and duration of the condition studied.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Primary aldosteronism: molecular medicine meets public health | 2023 | Review article Design not recorded in structured metadata | 48 | cc by PMID 37612380 · DOI · PMC7615304 |
| Diagnosis and management of primary hyperaldosteronism in patients with hypertension: a practical approach endorsed by the British and Irish Hypertension Society | 2024 | Review article Design not recorded in structured metadata | 25 | cc by PMID 37964158 · DOI · PMC10803267 |
| Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia | 2024 | Research article Design not recorded in structured metadata | 18 | cc by PMID 38261997 · DOI · PMC11180499 |
| Renin-aldosterone testing: The essentials | 2026 | Review article Design not recorded in structured metadata | 1 | cc by PMID 41933657 · DOI · PMC13127190 |
Primary aldosteronism: molecular medicine meets public health [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Primary aldosteronism is the most common single cause of hypertension and is potentially curable when only one adrenal gland is the culprit.
- Closing excerpt
- The disappearance of aldosterone synthesis and cells from most of the adult human zona glomerulosa is the likely driver of the mutational success that causes aldosterone-producing adenomas, but insights into the pathways that lead to constitutive aldosterone production and cell survival may open up opportunities for novel therapies.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (198 words)
Primary aldosteronism is the most common single cause of hypertension and is potentially curable when only one adrenal gland is the culprit. The importance of primary aldosteronism to public health derives from its high prevalence but huge under-diagnosis (estimated to be <1% of all affected individuals), despite the consequences of poor blood pressure control by conventional therapy and enhanced cardiovascular risk. This state of affairs is attributable to the fact that the tools used for diagnosis or treatment are still those that originated in the 1970-1990s. Conversely, molecular discoveries have transformed our understanding of adrenal physiology and pathology. Many molecules and processes associated with constant adrenocortical renewal and interzonal metamorphosis also feature in aldosterone-producing adenomas and aldosterone-producing micronodules. The adrenal gland has one of the most significant rates of non-silent somatic mutations, with frequent selection of those driving autonomous aldosterone production, and distinct clinical presentations and outcomes for most genotypes. The disappearance of aldosterone synthesis and cells from most of the adult human zona glomerulosa is the likely driver of the mutational success that causes aldosterone-producing adenomas, but insights into the pathways that lead to constitutive aldosterone production and cell survival may open up opportunities for novel therapies.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37612380 · DOI · PMC7615304
Diagnosis and management of primary hyperaldosteronism in patients with hypertension: a practical approach endorsed by the British and Irish Hypertension Society [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Alongside the lack of homogeneity among international guidelines and consensus documents on primary hyperaldosteronism, the National UK guidelines on hypertension do not provide extensive recommendations regarding the diagnosis and management of this condition.
- Closing excerpt
- Grading of recommendations was not performed in light of the limited available data from properly designed randomized controlled trials.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (202 words)
Alongside the lack of homogeneity among international guidelines and consensus documents on primary hyperaldosteronism, the National UK guidelines on hypertension do not provide extensive recommendations regarding the diagnosis and management of this condition. Local guidelines vary from area to area, and this is reflected in the current clinical practice in the UK. In an attempt to provide support to the clinicians involved in the screening of subjects with hypertension and clinical management of suspected cases of primary hyperaldosteronism the following document has been prepared on the behalf of the BIHS Guidelines and Information Service Standing Committee. Through remote video conferences, the authors of this document reviewed an initial draft which was then circulated among the BIHS Executive members for feedback. A survey among members of the BIHS was carried out in 2022 to assess screening strategies and clinical management of primary hyperaldosteronism in the different regions of the UK. Feedback and results of the survey were then discussed and incorporated in the final document which was approved by the panel after consensus was achieved considering critical review of existing literature and expert opinions. Grading of recommendations was not performed in light of the limited available data from properly designed randomized controlled trials.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37964158 · DOI · PMC10803267
Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia [3]
Abstract reading summary — source excerpts
- Opening excerpt
- ContextWhile guidelines have been formulated for the management of primary aldosteronism (PA), following these recommendations may be challenging in developing countries with limited health care access.
- Closing excerpt
- Future guideline revisions for PA may need to consider these limitations.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (247 words)
ContextWhile guidelines have been formulated for the management of primary aldosteronism (PA), following these recommendations may be challenging in developing countries with limited health care access.ObjectiveWe aimed to assess the availability and affordability of health care resources for managing PA in the Association of Southeast Asian Nations (ASEAN) region, which includes low-middle-income countries.MethodsWe instituted a questionnaire-based survey to specialists managing PA, assessing the availability and affordability of investigations and treatment. Population and income status data were taken from the national census and registries.ResultsNine ASEAN country members (48 respondents) participated. While screening with aldosterone-renin ratio is performed in all countries, confirmatory testing is routinely performed in only 6 countries due to lack of facilities and local assays, and cost constraint. Assays are locally available in only 4 countries, and some centers have a test turnaround time exceeding 3 weeks. In 7 countries (combined population of 442 million), adrenal vein sampling (AVS) is not routinely performed due to insufficient radiological facilities or trained personnel, and cost constraint. Most patients have access to adrenalectomy and medications. In 6 countries, the cost of AVS and adrenalectomy combined is more than 30% of its annual gross domestic product per capita. While most patients had access to spironolactone, it was not universally affordable.ConclusionLarge populations currently do not have access to the health care resources required for the optimal management of PA. Greater efforts are required to improve health care access and affordability. Future guideline revisions for PA may need to consider these limitations.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38261997 · DOI · PMC11180499
Renin-aldosterone testing: The essentials [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Primary aldosteronism (PA) is a common yet significantly underdiagnosed cause of secondary hypertension, estimated to affect around 9.
- Closing excerpt
- Improving PA screening offers a significant opportunity for substantial global benefit in reducing hypertension-related morbidity and mortality.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (158 words)
Primary aldosteronism (PA) is a common yet significantly underdiagnosed cause of secondary hypertension, estimated to affect around 9.4% of hypertensive adults. This is critical because patients with PA face markedly higher rates of adverse cardiovascular and renal outcomes, risks substantially mitigated by targeted treatment (surgery or medical therapy). Despite this, screening rates remain critically low. This article provides a practical, evidence-based approach to PA screening specifically for generalist settings, focusing on contemporary test interpretation and mitigating common pitfalls. Screening involves a simple blood test for plasma aldosterone and renin. The diagnostic hallmark is renin-independent aldosterone production, demonstrated by suppressed renin. While most antihypertensives interfere, the initial approach is to test patients on their current regimen. If results are inconclusive, medication withdrawal is warranted. Specialist referral is necessary when results are suggestive of PA, or in complex cases like chronic kidney disease. Improving PA screening offers a significant opportunity for substantial global benefit in reducing hypertension-related morbidity and mortality.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41933657 · DOI · PMC13127190
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis [5]
- Research article Study Heterogeneity and Estimation of Prevalence of Primary Aldosteronism: A Systematic Review and Meta-Regression Analysis [6]
- Research article Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline [7]
- Research article Diagnosis and treatment of primary aldosteronism [8]
- Research article Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension [9]
- Research article International Histopathology Consensus for Unilateral Primary Aldosteronism [10]
References
- Azizan EAB, Drake WM, Brown MJ. Primary aldosteronism: molecular medicine meets public health. . 2023. PMID 37612380 · DOI · PMC7615304
- Faconti L, Kulkarni S, Delles C, Kapil V, Lewis P, Glover M, et al.. Diagnosis and management of primary hyperaldosteronism in patients with hypertension: a practical approach endorsed by the British and Irish Hypertension Society. . 2024. PMID 37964158 · DOI · PMC10803267
- Sukor N, Sunthornyothin S, Tran TV, Tarigan TJ, Mercado-Asis LB, Sum S, et al.. Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia. . 2024. PMID 38261997 · DOI · PMC11180499
- Phillips EKT, Sathyanarayanan A. Renin-aldosterone testing: The essentials. . 2026. PMID 41933657 · DOI · PMC13127190
- Monticone S, D'Ascenzo F, Moretti C, Williams TA, Veglio F, Gaita F, et al.. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2018. PMID 29129575 · DOI
- Käyser SC, Dekkers T, Groenewoud HJ, van der Wilt GJ, Carel Bakx J, van der Wel MC, et al.. Study Heterogeneity and Estimation of Prevalence of Primary Aldosteronism: A Systematic Review and Meta-Regression Analysis. J Clin Endocrinol Metab. 2016. PMID 27172433 · DOI
- Adler GK, Stowasser M, Correa RR, Khan N, Kline G, McGowan MJ, et al.. Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2025. PMID 40658480 · DOI
- Reincke M, Bancos I, Mulatero P, Scholl UI, Stowasser M, Williams TA. Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol. 2021. PMID 34798068 · DOI
- Mulatero P, Monticone S, Deinum J, Amar L, Prejbisz A, Zennaro MC, et al.. Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension. J Hypertens. 2020. PMID 32890264 · DOI
- Williams TA, Gomez-Sanchez CE, Rainey WE, Giordano TJ, Lam AK, Marker A, et al.. International Histopathology Consensus for Unilateral Primary Aldosteronism. J Clin Endocrinol Metab. 2021. PMID 32717746 · DOI · PMC7765663
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.