Antihypertensive drugs and the diagnosis of hyperaldosteronism

What antihypertensive drugs can be used in a patient undergoing a diagnostic workup of primary hyperaldosteronism?

Ally Prebtani, MD: That is a good question. Many therapies, diseases, menopausal status, and estrogen status can affect interpretation of the aldosterone and renin when you are trying to work up someone for hyperaldosteronism, and different drugs have different effects. So when you do order these tests, you have to keep in mind what drugs the patients are on and what diseases they have, so you can interpret these properly.

But if you really want to investigate properly and you cannot interpret [the results] based on the drugs the patients are on, then the drugs that have minimal interference are either hydralazine, alfa₁-blockers, or long-acting nondihydropyridine calcium channel blockers such as verapamil or diltiazem.