Which anti-hypertensives do you hold and for how long when screening for hyperaldosteronism in a patient with resistant hypertension and initial screening with unsuppressed renin but elevated aldosterone >20 while on anti-hypertensive therapy?

When screening for hyperaldosteronism in a patient with resistant hypertension and an unsuppressed renin but elevated aldosterone >20 while on antihypertensive therapy, which medications do you hold for 2 to 4 weeks before confirmatory testing?

• Beta-blockers
• Diuretics
• ACE inhibitors / ARBs
• Spironolactone
• I do not routinely hold antihypertensives before confirmatory testing
• Other