A middle-aged patient with diabetes and hypertension presented to his primary care physician for regular health assessment. His blood pressure was 183/116 mm Hg despite taking lisinopril (40 mg/d) and verapamil (180 mg/d). He had previously taken hydrochlorothiazide, which was discontinued due to hypokalemia approximately 1 month ago, as well as atenolol, which was stopped 2 months earlier. As part of the workup for secondary hypertension, plasma aldosterone concentration and plasma renin activity were measured (Table 1).
Kumar B, Swee M. Aldosterone-Renin Ratio in the Assessment of Primary Aldosteronism. JAMA. 2014;312(2):184–185. doi:10.1001/jama.2014.64