CONSENSUS DOCUMENTSSubtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension∗Mulatero, Paoloa; Sechi, Leonardo A.b,†; Williams, Tracy Anna,c,†; Lenders, Jacques W.M.d,e,†; Reincke, Martinc; Satoh, Fumitoshif; Januszewicz, Andrzejg; Naruse, Mitsuhideh; Doumas, Michaeli; Veglio, Francoa; Wu, Vin Centj; Widimsky, JirikAuthor Information aDivision of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino bHypertension Unit, Internal Medicine, Department of Medicine DAME, University of Udine, Udine, Italy cMedizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany dDepartment of Internal Medicine HP 463, Radboud University Medical Center, Nijmegen, Nijmegen, Netherlands eDepartment of Medicine III, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany fDivision of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan gDepartment of Hypertension, National Institute of Cardiology, Warsaw, Poland hDepartment of Endocrinology, Metabolism and Hypertension, Clinical Research Institute, National Hospital Organization Kyoto Medical Center and Endocrine Center, Ijinkai Takeda General Hospital, Kyoto, Japan i2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece jDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan k3rd 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; APCC, aldosterone-producing cell cluster; ARR, aldosterone-to-renin ratio; AVS, adrenal vein sampling; CLR, contralateral ratio; CT, computed tomography; LI, lateralisation index; MR, magnetic resonance; MRAs, mineralocorticoid receptor antagonists; RAAS, renin—angiotensin--aldosterone system; SI, selectivity index Received 14 January, 2020 Revised 11 April, 2020 Accepted 29 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 1929-1936 doi: 10.1097/HJH.0000000000002520 Buy SDC Metrics Abstract Primary aldosteronism is a frequent cause of secondary hypertension requiring a specific pharmacological treatment with mineralocorticoid receptor antagonist or with unilateral adrenalectomy. These treatments have shown to reduce the excess of cardiovascular risk characteristically associated with this disease. In part I of this consensus, we discussed the procedures for the diagnosis of primary aldosteronism. In the present part II, we address the strategies for the differential diagnosis of primary aldosteronism subtypes and therapy. We also discuss the evaluation of outcomes and provide suggestions for follow-up as well as cardiovascular and metabolic complications specifically associated with primary aldosteronism. Finally, we analyse the principal gaps of knowledge and future challenges for research in this field. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.