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October 7, 1961

Useful Parameters in the Diagnosis of Primary Aldosteronism

Author Affiliations

San Francisco

Assistant Research Physician and Clinical Assistant Professor (Dr. Biglieri), Chief Resident in Medicine (Dr. Slaton), and Director Metabolic Unit, Professor of Medicine and Pediatrics (Dr. Forsham), University of California Medical School. Dr. Biglieri is Special Post-doctoral Research Fellow for the National Institutes of Health. Dr. Slaton was trainee for the National Institutes of Arthritis and Metabolic Diseases.

JAMA. 1961;178(1):19-22. doi:10.1001/jama.1961.03040400021004

Based upon observations in 5 surgically proved cases of primary aldosteronism, laboratory tests were sought that might prove useful in diagnosis. The data revealed that plasma volumes were well above the normal range, in contrast to the levels seen in other forms of hypertension. In each case the low serum potassium level rose toward normal after oral administration of spironolactone, 1 gm. daily for 3 days, in contrast to the near absence of a response in patients with essential hypertension. Rigorous sodium restriction led to potassium retention. Such observations should furnish strong presumptive evidence for a diagnosis of primary aldosteronism.