Summary
Definition
History and exam
Other diagnostic factors
- age 20 to 70 years
- nocturia, polyuria
- lethargy
- mood disturbance (irritability, anxiety, depression)
- difficulty concentrating
- paraesthesias, muscle cramps
- muscle weakness
- palpitations
Risk factors
- family history of PA
- family history of early onset of hypertension and/or stroke
Diagnostic investigations
Investigations to consider
- fludrocortisone suppression test
- saline infusion testing
- oral salt loading
- genetic testing for hybrid gene
- adrenal CT
- adrenal venous sampling
- adrenal MRI
- adrenal selenocholesterol scanning
- posture stimulation testing
- angiotensin II infusion testing
- 24-hour urinary hybrid steroids (18-hydroxy- and 18-oxo-cortisol)
- dexamethasone suppression testing
Treatment algorithm
Contributors
Authors

Professor
Endocrine Hypertension Research Centre
University of Queensland School of Medicine
Greenslopes and Princess Alexandra Hospitals
Brisbane
Queensland
Australia
Disclosures
MS is an author of references cited in this monograph.

Professor
Endocrine Hypertension Research Centre
University of Queensland School of Medicine
Greenslopes and Princess Alexandra Hospitals
Brisbane
Queensland
Australia
Disclosures
RDG is an author of references cited in this monograph.
Peer reviewers
Department of Medicine and Experimental Oncology
Division of Medicine and Hypertension
San Giovanni Battista Hospital
Torino
Italy
Disclosures
PM declares that he has no competing interests.
Clinical Professor
Department of Family Medicine
University of North Carolina
Chapel Hill
Assistant Program Director
MAHEC Rural Family Medicine Residency
Hendersonville
NC
Disclosures
WM declares that he has no competing interests.
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