Is adequate BP control sufficient enough when titrating spironolactone therapy for primary hyperaldosteronism treatment?  

Good blood pressure control is one of the three major goals of medical treatment of primary aldosteronism. Titrating spironolactone (or eplerenone) to an adequate blood pressure (often with reduction or cessation of other anti-hypertensives) is often the first goal met with dose adjustment. The seco...

In addition to BP control, we would push the dose of MR higher until we get a PRA >1 ng/ml/hr unless there are other issues, such as the development of hyperkalemia.