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Abstract:Objective: To determine the prevalence of Primary Aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA.Methods: An ARR (cutoff ≥20, with PAC ≥ 10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (BP ≥ 140/90) over the age of 18 from August 2012 through May 2013.Subjects who screened positive then underwent confirmatory oral salt load testing (OSLT).Results: Of the 296 patients, fourteen screened positive for PA, an overall prevalence of 4.7%. Six of the fourteen cases underwent confirmatory OSLT upon which two confirmed positive, prevalence of 0.7%.Overall, patients with confirmed PA were more likely to have resistant hypertension (42.9% vs. 18.1% (p= 0.0334)) and require more anti-hypertensive agents (2.8 ±1.2 agents vs 2.1 ± 1.1 agents (p=0.0213)).There was a trend toward lower potassium values in the cases.Conclusion: The prevalence of PA in our clinic is much lower than in reports from certain "at-risk" populations. PA screening is indicated in patients with resistant hypertension, regardless of serum potassium levels. Introduction: