CONSENSUS DOCUMENTSGenetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension∗Mulatero, Paoloa; Monticone, Silviaa,†; Deinum, Jaapb,c,†; Amar, Laurenced,†; Prejbisz, Aleksandere,†; Zennaro, Maria-Christinaf,g; Beuschlein, Felixh,i; Rossi, Gian Paoloj; Nishikawa, Tetsuok; Morganti, Albertol; Seccia, Teresa Mariaj; Lin, Yen-Hungm; Fallo, Francescon; Widimsky, JirioAuthor Information aDivision of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy bDepartment of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands cDepartment of Medicine III, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany dHypertension Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Université de Paris, PARCC, Inserm, Paris, France eDepartment of Hypertension, National Institute of Cardiology, Warsaw, Poland fUniversité de Paris, PARCC, INSERM, Paris, France gAssistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France hKlinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland iMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany jHypertension Unit and Specialized Center for Blood Pressure Disorders - Department of Medicine-DIMED, University of Padova, Padova, Italy kEndocrinology and Diabetes Center, Yokohama Rosai Hospital, Yokohama, Japan lCentro Fisiologia Clinica e Ipertensione, Ospedale Policlinico, Università di Milano, Milan, Italy mDivision of cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan nDepartment of Medicine -DIMED, University of Padova, Padova, Italy o3rd Department of Medicine, Center for Hypertension, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic Correspondence to Paolo Mulatero, MD, Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Via Genova 3, 10126 Torino, Italy. Tel: +39 116336997; fax: +39 116336931; e-mail: firstname.lastname@example.org Abbreviations: ACTH, adrenocorticotropic hormone; APA, aldosterone-producing adenoma; ARR, aldosterone-to-renin ratio; DRC, direct renin concentration; GRA, glucocorticoid remediable aldosteronism; LCMS/MS, liquid chromatography and tandem mass spectrometry; MRAs, mineralocorticoid receptor antagonists; OSA, obstructive sleep apnea; PAC, plasma aldosterone concentration; PASNA, primary aldosteronism with seizures and neurologic abnormalities; PRA, plasma renin activity; RAS, renin--angiotensin system Received 14 January, 2020 Revised 30 March, 2020 Accepted 20 April, 2020 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com). Journal of Hypertension: October 2020 - Volume 38 - Issue 10 - p 1919-1928 doi: 10.1097/HJH.0000000000002510 Buy SDC Metrics Abstract Autonomous aldosterone overproduction represents the underlying condition of 5–10% of patients with arterial hypertension and carries a significant burden of mortality and morbidity. The diagnostic algorithm for primary aldosteronism is sequentially based on hormonal tests (screening and confirmation tests), followed by lateralization studies (adrenal CT scanning and adrenal venous sampling) to distinguish between unilateral and bilateral disease. Despite the recommendations of the Endocrine Society guideline, primary aldosteronism is largely underdiagnosed and undertreated with high between-centre heterogeneity. Experts from the European Society of Hypertension have critically reviewed the available literature and prepared a consensus document constituting two articles to summarize current knowledge on the epidemiology, diagnosis, treatment, and complications of primary aldosteronism. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.