Hypertension is frequently treated as essential hypertension. However, secondary causes of hypertension should be considered, because distinct treatments are used for different causes of hypertension. Primary aldosteronism is considered a candidate for the most common cause of secondary hypertension. Despite the effects of many antihypertensive agents on the renin-angiotensin-aldosterone system, ongoing efforts to manage hypertension should not be discontinued solely for the purposes of screening. If a patient presents with new or untreated hypertension, screening should be considered before starting antihypertensive agents that could affect the renin-angiotensin-aldosterone system.