The Endocrine Society has issued a clinical practice guideline on the management of primary aldosteronism.

For high-risk groups of hypertensive patients and those with hypokalemia, it recommends detection by determining the aldosterone-renin ratio under standard conditions. It also suggests using common testing methods to confirm or exclude the condition.

Additionally, it recommends that:

• All patients with primary aldosteronism undergo adrenal computed tomography as the initial study in subtype testing and to exclude adrenocortical carcinoma.

• An experienced radiologist establishes or excludes unilateral primary aldosteronism using bilateral adrenal venous sampling; if confirmed, treat by laparoscopic adrenalectomy.

• Patients with bilateral adrenal hyperplasia or those unsuitable for surgery be treated primarily with a mineralocorticoid receptor antagonist.