Primary Aldosteronism explained presented by Associate Professor Jun Yang, MBBS, FRACP, PhD
Primary Aldosteronism (PA) is the most commonly under-diagnosed cause of high blood pressure affecting millions of people. While previously considered as rare, PA has been found to affect up to 30 per cent of people with resistant hypertension.
When seeing a client with hypertension, primary aldosteronism should be on every clinician’s radar. It significantly increases cardiometabolic risk, including heart failure, stroke, and kidney disease, even when blood pressure appears controlled.
Professor Yang outlines how excess aldosterone drives sodium retention and potassium loss, contributing to hypertension, inflammation, fibrosis, and long-term cardiovascular damage. Initial screening is simple; a blood test measuring aldosterone and renin, yet screening remains rare. Treatment with either medication and/or surgery can normalise blood pressure and reverse organ damage.
For dietitians, the key message is the crucial role of sodium reduction. Evidence supports aiming for less than 1,500 mg sodium daily to enhance medical outcomes. Dietitians can also play an advocacy role by asking clients with difficult-to-control hypertension whether they’ve been screened for primary aldosteronism.