High Blood Pressure (Hypertension) Caused by Adrenal Tumors

Hypertension or high blood pressure (HBP) is one of the most common diseases in the world and many people have it because of an adrenal tumor and they don't even know it. High blood pressure is the major risk factor for stroke, heart disease, and heart arrhythmias. It is estimated that almost a quarter (25%) of the entire world’s population have hypertension. That means about 1 billion adults. In the United States, is estimated that about one in four (1/4; about 75 million) adults have high blood pressure or is taking antihypertensive medications. A normal systolic blood pressure is between 90 to 129 mmHg where is the diastolic pressure should be between 60 and 79 mmHg.

Can high blood pressure be cured? Since many patients with high blood presure have an adrenal tumor as the cause, yes, removing the adrenal tumor can improve and often completly cure the high blood pressure. Learn here about how a short mini-adrenal operation can potentially cure you of high blood pressure and thereby decrease your chance of stroke, heart attack, and sudden death.

Classification of Types of Hypertension (High Blood Pressure)
Type Systolic Diastolic
Normal Less than 120 Less than 80
Pre-Hypertension 120 - 139 80 -90
Stage 1 Hypertension 140 - 159 90 -99
Stage 2 Hypertension 160 - 179 100 -109
Hypertensive Crisis Over 180 Over 110

Hypertension is a difficult problem because it is rarely accompanied by symptoms. That means that the patient is asymptomatic and unless they have their blood pressure checked they will not know that there they are hypertensive. However, if symptoms occur it can be reported as headaches, lightheadedness, vertigo, tinnitus, altered vision or even fainting.

Primary Hypertension.In most cases high blood pressure is due to what we call "primary hypertension". This means that there is no underlying cause of the high blood pressure. Primary hypertension is the most common form of high blood pressure and it can only be treated with medications.

Secondary Hypertension. Secondary hypertension means that there is an identifiable cause that is underlying the high blood pressure. In other words, patients with secondary hypertension have something causing it--and often this is an adrenal tuomr. In these cases, hypertension can be cured, often with a safe straightforward mini-back-scope operation. This is why it is very important for doctors to not just treat the high blood pressure with medications without figuring out why the patient has high blood pressure in the first place.

Adrenal Tumors are the Most Common Cause of Secondary Hypertension

The most common cause of secondary hypertension has to do with adrenal hormones, and tumors that overproduce these hormones. This is what is called "endocrine hypertension" (endocrine means hormone). This is high blood pressure due to an adrenal tumor. It is estimated that 15 % of all cases of high blood pressure are due to an underlying adrenal tumor problem. This means that there are about 10 million patients in the United States that suffer from this problem. Unfortunately, only a minute fraction of these patients is correctly diagnosed, treated and referred for possible curative surgery (adrenalectomy).

All 4 classes of adrenal hormones can cause high blood pressure. These four classes of adrenal hormones are: 1) aldosterone, 2) cortisol, 3) catecholamines, and 4)sex-steroid hormones. Over production of all of these hormones can cause secondary hypertension. That means primary hyperaldosteronism, Cushing’s syndrome, pheochromocytomas sex-steroid are all associated with hypertension.

Interestingly, each of the different adrenal hormones cause slightly different types of hypertension and with different symptoms. For instance, patients with Cushing’s syndrome due to an adrenal cortical tumor that is over producing cortisol produces sustained relatively mild to moderate hypertension. Patients with a tumor over producing aldosterone typically causes sustained moderate to high hypertension, sometimes where the diastolic is worse than the systolic. Patients with pheochromocytoma (or paraganglioma) may have completely normal baseline blood pressure but then have abrupt episodes (paroxysmal) of very severely elevated blood pressure often together with headaches, palpitations, pallor (pale face) and sweating.

Important information: Most, but not all patients with primary hyperaldosteronism (Conn tumor), Cushing’s syndrome, and pheochromocytoma have baseline hypertension. In fact, almost half of patients with pheochromocytoma or paraganglioma are normotensive (meaning having normal blood pressure) during large parts of the day.


Who Should be Tested for Adrenal Tumor as Cause of High Blood Pressure?

If you belong to any of this groups of patients with hypertension you need to make sure you do not have an adrenal tumor that is causing your high blood pressure:
  • Resistant hypertension (i.e. poor response to medications).
  • Hypertension requiring two or more blood pressure medications.
  • Hypertension requiring being on Spironolactone (Aldactone), Eplerenone (Inspra) or Amiloride.
  • Hypertension of any grade, without known risk factors such as age, smoking kidney problems, diabetes, obesity, etc.
  • Hypertension at a young age (< 50 years of age).
  • Hypertension with low blood potassium (hypokalemia) (this classic for Conn's Syndrome).
  • Hypertension with an adrenal incidentaloma (adrenal tumor found when x-raying for something else).
  • Hypertension and sleep apnea.
  • Hypertension and a family history of early-onset (< 50 years of age) hypertension or cerebrovascular accident at a young age.
  • Hypertension in a family with any family member with an adrenal tumor (whether a Conn's Syndrome tumor, Cushing’s Syndrome, or pheochromocytoma/paraganglioma).
  • Hypertension that is episodic - it comes and goes (paroxysmal).

Important to know! There are other causes of secondary hypertension not related to the adrenal gland. One such disease is primary hyperparathyroidism, due to one or more parathyroid tumors. To learn more about parathyroid disease, tumors, and curative parathyroid surgery visit our sister page here. Endocrine hypertension can also be caused by diseases of the thyroid gland. Learn about thyroid disease, tumors, hyperthyroidism and curative thyroid surgery at our other sister page here. Other rarer causes of secondary hypertension include those related to changes in the major blood vessels in your body.