Overnight Dexamethasone in Primary Aldosteronism Screening

Inclusion Criteria: * suspected or diagnosed HT, * age between 40 and 75, * available aldosterone and renin result at the time of one-day clinic stay, * scheduled 1-mg-DXM test (indicated for possible mild autonomous cortisol secretion, MACS), * presence of an adrenal lesion with radiologic features of adrenocortical adenoma/hyperplasia. Exclusion Criteria: * baseline (pre-DXM) hyperreninemia (renin exceeding the upper limit of normal at the study site, i.e. 46.1 mIU/l, assay manufacturer: Diasorin), * baseline (pre-DXM) Ald\<3 ng/dl, * overt clinical and/or biochemical features of adrenal hormone deficiency or excess other than MACS (8 a.m. cortisolemia in the 50-140 nmol/l range in the 1-mg DXM test), * therapy with glucocorticoids, non-steroidal anti-inflammatory drugs, hormonal replacement therapy, hormonal contraceptive therapy, and/or licorice intake, * established or suspected secondary HT other than due to PA, * comorbidities including: poorly controlled and/or other than type 2 diabetes mellitus (T2DM), present and past alcohol abuse, obesity grade 3 (i.e. body mass index of at least 40 kg/m2), severe CV disease disqualifying a patient from chronic medication modification, active malignancy, decompensated autoimmune disease as well as an autoimmune disease associated with cardiovascular and/or renal complications, estimated glomerular filtration rate (eGFR) below 45 ml/min/1.73m2, poor physical condition, lack and withdrawal of consent for participation.