In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?

If the screening test is convincing (PRA suppressed and plasma Aldosterone >15) I would repeat confirmatory testing. If the first test was saline suppression I would do salt loading and a 24 h urine collection, and vice versa. These confirmatory tests are useful but do not have high sensitivity. If ...