Primary aldosteronism (hyperaldosteronism) Quiz: Ace Your Exams
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A 38-year-old man presents to the clinic with a four-month history of uncontrolled hypertension, despite taking three antihypertensive medications. His past medical history is significant for hyperlipidemia. There is no family history of early onset adrenal adenoma, hypertension, or cerebral vascular disease. His BMI is 31 kg/m2, temperature is 36.7°C (98.1°F), blood pressure is 170/105 mmHg, pulse is 76/min, respiratory rate is 18/min, and oxygen saturation is 100% on room air. Physical examination is unremarkable. Laboratory studies are listed below. In addition to potassium supplementation, which of the following is the best next step in management?
| Laboratory value | Result |
| Sodium | 144 mEq/L |
| Potassium | 2.8 mEq/L |
| Bicarbonate | 29 mEq/L |
| Plasma aldosterone | 25 ng/dL |
| Plasma renin activity | 0.8 ng/mL/hr |
| Plasma aldosterone:renin ratio | 31.25 |
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