Overview

Primary aldosteronism (al-DOS-tuh-ro-niz-um) is a type of hormonal disorder that leads to high blood pressure. Your adrenal glands produce a number of essential hormones. One of these is aldosterone, which balances sodium and potassium in your blood.

In primary aldosteronism, your adrenal glands produce too much aldosterone, causing you to lose potassium and retain sodium. The excess sodium in turn holds on to water, increasing your blood volume and blood pressure.

Diagnosis and treatment of primary aldosteronism are important because people with this form of high blood pressure have a higher risk of heart disease and stroke. Also, the high blood pressure associated with primary aldosteronism may be curable.

Options for people with primary aldosteronism include medications, lifestyle modifications and surgery.

Symptoms

The main signs of primary aldosteronism are:

  • Moderate to severe high blood pressure
  • High blood pressure that takes several medications to control (resistant hypertension)
  • High blood pressure along with a low potassium level (hypokalemia)

When to see a doctor

Have your blood pressure checked regularly, especially if you have risk factors for high blood pressure. Ask your doctor about the possibility of having primary aldosteronism if:

  • You're age 45 or older
  • You have a family history of high blood pressure
  • You have high blood pressure that began at age 44 or younger
  • You're overweight
  • You have a sedentary lifestyle
  • You use tobacco
  • You drink a lot of alcohol
  • You have dietary imbalances (too much salt, not enough potassium)

Causes

Common conditions causing the overproduction of aldosterone include:

  • A benign growth in an adrenal gland (aldosterone-producing adenoma) — a condition also known as Conn's syndrome
  • Overactivity of both adrenal glands (idiopathic hyperaldosteronism)

In rare cases, primary aldosteronism may be caused by:

  • A cancerous (malignant) growth of the outer layer (cortex) of the adrenal gland (adrenal cortical carcinoma)
  • A rare type of primary aldosteronism called glucocorticoid-remediable aldosteronism that runs in families and causes high blood pressure in children and young adults

Complications

Primary aldosteronism can lead to high blood pressure and low potassium levels. These complications in turn can lead to other problems.

Problems related to high blood pressure

Persistently elevated blood pressure can lead to problems with your heart and kidneys, including:

  • Heart attack
  • Heart failure
  • Left ventricular hypertrophy — enlargement of the muscle that makes up the wall of the left ventricle, one of your heart's pumping chambers
  • Stroke
  • Kidney disease or kidney failure
  • Premature death

High blood pressure caused by primary aldosteronism carries a higher risk of cardiovascular complications than do other types of high blood pressure. This excess risk is due to the high aldosterone levels, which can cause heart and blood vessel damage independent of complications related to high blood pressure.

Problems related to low potassium levels

Some, but not all, people with primary aldosteronism have low potassium levels (hypokalemia). Mild hypokalemia may not cause any symptoms, but very low levels of potassium can lead to:

  • Weakness
  • Cardiac arrhythmias
  • Muscle cramps
  • Excess thirst or urination
Nov. 02, 2016
References
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