New insights into the medical management of primary aldosteronism.

Case Presentation A 30-year-old woman was admitted to the hospital because of hypertension and hypokalemia. She had had a normal blood pressure measurement 5 years prior to admission and had been in good health until approximately 1 year before admission when a severe frontal headache and cramping in her hands and feet developed. She was seen in an emergency room and was noted to be hypertensive with a blood pressure of 170/100 mm Hg She was treated with methyldopa (Aldomet), and a blood sample analysis yielded the following values: serum sodium, 142 mEq/L; serum potassium, 2.2 mEq/L; CO2 level, 35 mEq/L; blood urea nitrogen, 13 mg/dl; and glucose, 91 mg/dl. Electrocardiogram (ECG) was normal except for the presence of U waves. An intravenous pyelogram was normal. While on the methyldopa regimen, the patient's headaches resolved; however, 9 months before admission, the patient discontinued all medications and her headaches returned. Three months before admission