Things We Do for No Reason™: Failing to consider primary aldosteronism in the initial evaluation of hypertension, hypertensive urgency, and hypertensive emergency

Hypertension is frequently treated as essential hypertension. However, secondary causes of hypertension should be considered, because distinct treatments are used for different causes of hypertension. Primary aldosteronism is considered a candidate for the most common cause of secondary hypertension. Despite the effects of many antihypertensive agents on the renin–angiotensin–aldosterone system, ongoing efforts to manage hypertension should not be discontinued solely for the purposes of screening. If a patient presents with new or untreated hypertension, screening should be considered before starting antihypertensive agents that could affect the renin–angiotensin–aldosterone system.