1. - High renin sec. -> high aldosteron =Secondary hyper-aldosteronism ( MCC renal artery stenosis, juxtaglomerular renin secreting cell tumor) - normal or low renin & High aldosteron sec. = Primary hyper-aldosteronism ( MCC bilateral idiopathic adrenal hyperplasia, or Conn's Disease(=Adenoma) ) - ACE Inhibitors are the best Rx. for HTN in pt. with Renal failure & DM
2. Hypertension=higher than 140/60, or higher than 130/80 in DM
   1. 1ry=essensial=MCC
   2. 2ry
      1. hypo-k
         1. Plasma Aldosterone to Renin ratio
            1. High i.e 30 or more
            2. Dx. Primary hyperaldosteronism(Conn's or Hyperplasia)
            3. Dx.Conn's
            4. Rx. Surgery
            5. Dx. hyperplasia
            6. Rx. spironolactone
            7. low
            8. Dx. juxtaglomerular tumor
         2. stenosis of renal artery ->bruit
            1. renal artery stenosis (=Secondary hyper-aldosteronism )
            2. young female
            3. Fibromuscular type
            4. Rx. Surgery
            5. old male
            6. atherosclerotic type
            7. Inv. MR is better then CT angiography
3. Hypotension=Shock=lower than 90/60