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• Posted July 16, 2025

Doctors Overlooking Common Cause Of High Blood Pressure, New Guidelines Say

Doctors are regularly overlooking a common hormone-driven cause of high blood pressure, a new paper warns.

As many as 30% of high blood pressure patients seen by heart specialists and 14% of those seen in primary care have a condition called primary aldosteronism, researchers reported in the Journal of Clinical Endocrinology & Metabolism.

Despite this, many are never given a blood test for the condition, in which the adrenal glands produce too much of the hormone aldosterone, researchers said.

Others are tested years after their initial diagnosis with high blood pressure. By that time, the condition has caused severe health complications, researchers added.

“People with primary aldosteronism face a higher risk of cardiovascular disease than those with primary hypertension,” said lead author Dr. Gail Adler, an endocrinologist at Brigham and Women’s Hospital in Boston.

“With a low-cost blood test, we could identify more people who have primary aldosteronism and ensure they receive the proper treatment for the condition,” she added in a news release.

Aldosterone helps balance blood levels of sodium and potassium, researchers said. Levels that are too high can cause people to lose potassium while retaining more sodium, resulting in increased blood pressure.

Research has shown that people with primary aldosteronism are nearly 2.6 times more likely to have a stroke; twice as likely to have heart failure; 3.5 times more likely to develop an abnormal heart rhythm; and 77% more likely to wind up with heart disease, researchers said in background notes.

Guidelines offered in the new paper recommend that everyone diagnosed with high blood pressure have their aldosterone levels checked, and those with primary aldosteronism be given treatment specific to that condition.

Prescription drugs are available to treat primary aldosteronism, according to Johns Hopkins Medicine. They include spironolactone and eplerenone, both of which lower blood pressure and boost potassium levels.

Doctors also might recommend surgery to remove one of the two adrenal glands, if only one is producing too much aldosterone, researchers said.

Patients also are asked to eat a balanced low-sodium diet and try to lose weight, Johns Hopkins said.

More information

Johns Hopkins Medicine has more on primary aldosteronism.

SOURCES: Journal of Clinical Endocrinology & Metabolism, July 14, 2025; Endocrine Society, news release, July 14, 2025