Experts from the Endocrine Society are urging doctors to screen more people for a common but often overlooked hormonal cause of high blood pressure, called primary aldosteronism.
Their updated guideline, titled “Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline,” was recently published online and presented at the ENDO 2025 meeting.
Many people with high blood pressure might actually have undiagnosed primary aldosteronism.
Research shows that between 5% to 14% of people with high blood pressure seen in primary care, and up to 30% of those seen in specialist clinics, may have this condition—but most are never tested for it.
Primary aldosteronism happens when the adrenal glands (located on top of the kidneys) produce too much of a hormone called aldosterone. This hormone controls the balance of sodium and potassium in the body.
When aldosterone levels are too high, it can cause high blood pressure, which is often the only noticeable symptom.
Without proper diagnosis and treatment, primary aldosteronism can increase the risk of serious heart and kidney problems, including stroke, heart failure, atrial fibrillation, and kidney disease.
“People with primary aldosteronism face a higher risk of cardiovascular disease than those with regular high blood pressure,” said Dr. Gail K. Adler, who led the guideline writing group.
She is a doctor and researcher at Brigham and Women’s Hospital and Harvard Medical School in Boston.
The new guideline encourages healthcare providers to use a simple blood test to check for aldosterone, renin, and potassium levels in all patients diagnosed with high blood pressure.
While the guideline does not strongly require universal testing—since false positives can occur—it does recommend considering the test for most patients to catch more undiagnosed cases.
If someone is diagnosed with primary aldosteronism, doctors can offer targeted treatments. These may include medications to block the effects of aldosterone or surgery to remove the adrenal gland if only one is overactive.
This new guideline updates the Society’s previous recommendations from 2016. It will also be published in the September 2025 print issue of *The Journal of Clinical Endocrinology & Metabolism*.
The Endocrine Society’s guidelines are created by expert panels who review all the latest research to ensure that the recommendations are based on solid scientific evidence. The goal is to give doctors and healthcare professionals better tools to diagnose and treat hormone-related conditions like primary aldosteronism.
In summary, a low-cost blood test could help find more people with this hidden cause of high blood pressure. Earlier detection and treatment may prevent serious complications and help patients live healthier lives.
The study is published in The Journal of Clinical Endocrinology & Metabolism.
Copyright © 2025 Knowridge Science Report. All rights reserved.
