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GMJ News > GMJ Briefs > Resistant Hypertension and Primary Aldosteronism: A Diagnostic Opportunity

Resistant Hypertension and Primary Aldosteronism: A Diagnostic Opportunity

GMJ
Last updated: 27/09/2026 21:27
By
Prof. Giorgi Pkhakadze, MD, MPH, PhD
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Diagram showing adrenal glands and primary aldosteronism pathophysiology
Primary aldosteronism causes 5–15% of hypertension cases but remains underdiagnosed globally. A Nature Reviews Disease Primers review highlights improved screening protocols, diagnostic pathways, and treatment outcomes in this important but overlooked endocrine disorder. — Photo by Mikhail Nilov on Pexels (Pexels License)
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1 min read|128 words

Among patients with treatment-resistant hypertension, primary aldosteronism accounts for up to 15% of cases—yet systematic screening remains uncommon in clinical practice. This statistic, drawn from a comprehensive Nature Reviews Disease Primers analysis, underscores a significant diagnostic gap that has major implications for patient management and cardiovascular outcomes.

Early and accurate diagnosis of primary aldosteronism enables clinicians to shift from empirical multi-drug therapy to targeted, mechanism-based treatment strategies. Patients with unilateral adenomas may achieve normotension or substantial blood pressure reduction through adrenalectomy, while those with bilateral disease benefit from mineralocorticoid receptor antagonists and careful metabolic monitoring.

Implementing systematic screening protocols in high-risk populations—particularly those with resistant hypertension, early-onset hypertension, or hypokalemia—can prevent disease-related cardiovascular complications and improve long-term clinical outcomes. Read the full article on GMJ Newsroom.

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📰 Read the full article: Primary aldosteronism: why screening for this overlooked cause of hypertension matters →

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ByProf. Giorgi Pkhakadze, MD, MPH, PhD
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MD, MPH, PhD. Editor-in-Chief, Georgian Medical Journal (GMJ). Professor and Head, School of Public Health, David Tvildiani Medical University (DTMU), Tbilisi, Georgia. Chair, Public Health Institute of Georgia (PHIG). President, Accréditation Sans Frontières (ASF), Paris. Secretary/Treasurer, UEMS Section of Public Health. WHO Consultant, Health and Migration, Geneva. Former Member, UN Secretary-General's Independent Accountability Panel for Every Woman, Every Child, Every Adolescent (IAP-EWEC, 2016–2021). ORCID: 0000-0001-7609-4515.

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