What is the most likely diagnosis?

A 45-year-old woman was found to be hypertensive by her general practitioner. She was otherwise well and was not taking any medication. However, she regularly ate health food containing liquorice. There was no family history of significant illness.

On examination, her blood pressure was 170/110 mmHg.

Investigations:

serum sodium140 mmol/L (137C144)

serum potassium3.8 mmol/L (3.5C4.9)

serum creatinine70 µmol/L (60C110)

plasma renin activity (after 30 min supine)0.5 pmol/mL/h (1.1C2.7)

plasma aldosterone (after 30 min supine)450 pmol/L (135C400)

During the investigations, her blood pressure was controlled with doxazosin.

What is the most likely diagnosis?
A . apparent mineralocorticoid excess
B . Gitelman’s syndrome
C . primary hyperaldosteronism
D . pseudohyperaldosteronism
E . renal artery stenosis

Answer: C

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