A clinical update on Primary Aldosteronism; Are we seeing only the tip of an iceberg?

Primary Aldosteronism (PA) is a common form of secondary hypertension, often undiagnosed, untreated, and overlooked leading to excess cardiovascular morbidity and mortality. Until recently it is being recognized as a binary disease. Recent evidence suggests PA is a disease spanning a continuum from subclinical stages to more florid disease manifesting as Conn’s syndrome. Timely diagnosis and appropriate surgical intervention can cure hypertension in PA whereas it can reduce hypertension-related target organ damage and excess mortality and morbidity associated with aldosterone excess. Unfortunately, most clinicians are still in the dark with regard to the pitfalls of diagnosing PA, thus detecting only the tip of the iceberg.