Prospective Phenotyping of Autonomous Aldosterone Secretion

This prospective cohort study will investigate the physiology and progression of autonomous aldosterone secretion.

Inclusion Criteria: 1. Age 35-70 years 2. Systolic blood pressure of 120-135 mmHg and/or diastolic blood pressure of 75-85 mmHg 3. At least one, or more, of the following: * BMI ≥ 25 kg/m2 * Family history of hypertension prior to the age of 60 years in a parent or sibling * Diabetes with a hemoglobin A1c \< 9% 4. If systolic blood pressure 115-135 mmHg and/or diastolic blood pressure 70-85 mmHg, must have two or more of the following: * BMI ≥ 25 kg/m2 * Family history of hypertension prior to the age of 60 years in a parent or sibling * Diabetes with a hemoglobin A1c \< 9% Exclusion Criteria: * Known history of hypertension or use of antihypertensive medications * Known history of stroke, coronary artery disease, myocardial infarction, heart failure, cerebral or aortic aneurysm, or preeclampsia. * Active cancer that is being treated with chemotherapeutic agents * Pregnancy * Breast feeding * Daily use of prescribed opioid medications * Illicit drug use (cocaine, heroin, methamphetamine) * Daily non-steroidal anti-inflammatory medication use * Daily use of glucocorticoids * Electrocardiogram that shows evidence of prior myocardial infarction, atrial arrhythmia, left or right bundle branch blocks. * Estimated glomerular filtration rate \< 60 mL/min/1.73m2 * Active and untreated hyper- or hypo-thyroidism * Abnormal screening laboratories (comprehensive metabolic panel, complete blood count, thyrotropin) * BMI ≥ 45 kg/m2