[Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].
AJ, D.R.F., A, G.L.P., & E, R.E. (2026). [Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].. Anales del sistema sanitario de Navarra. https://doi.org/10.23938/ASSN.1174
AJ DRF, A GLP, E RE. [Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].. Anales del sistema sanitario de Navarra. 2026; doi: 10.23938/ASSN.1174
AJ DRF, A GLP, E RE. [Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].[J]. Anales del sistema sanitario de Navarra. 2026. DOI: 10.23938/ASSN.1174.
@article{aj2026,
author = {Del Rey Fernández AJ and Garcia-Luengo Pensado A and Reyzabal Ereño E},
title = {[Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia].},
journal = {Anales del sistema sanitario de Navarra},
year = {2026},
doi = {10.23938/ASSN.1174},
note = {PMID: 42657992},
}
TY - JOUR AU - Del Rey Fernández AJ AU - Garcia-Luengo Pensado A AU - Reyzabal Ereño E TI - [Primary aldosteronism in resistant hypertension unmasked by a thiazide-induced severe hypokalaemia]. T2 - Anales del sistema sanitario de Navarra PY - 2026 DO - 10.23938/ASSN.1174 AN - PMID:42657992 ER -
Primary aldosteronism is the most common cause of secondary hypertension but remains frequently underdiagnosed in primary care. We report a 71-year-old man with resistant hypertension and low-normal serum potassium in whom a minimal increase in hydrochlorothiazide dosage (12.5 to 25 mg) precipitated severe hypokalaemia (1.6 mmol/L), metabolic alkalosis, and rhabdomyolysis. An office electrocardiogram showed hypokalaemia-related changes, prompting urgent referral to the emergency department. Further evaluation revealed an elevated aldosterone-to-renin ratio and a left adrenal nodule, supporting the diagnosis of primary aldosteronism. This case highlights the importance of recognizing a disproportionate hypokalaemic response to thiazide treatment as a potential indicator of underlying primary aldosteronism. It also underscores the role of family physicians in early detection through appropriate screening.