What Is Primary Aldosteronism?
Primary aldosteronism occurs when your adrenal glands produce excessive amounts of aldosterone—a hormone that helps control blood pressure and electrolyte levels. Too much aldosterone causes the body to retain sodium and lose potassium, which increases blood pressure. This condition is also referred to as "Conn’s syndrome" when caused by a tumor on one adrenal gland.
Why Primary Aldosteronism Matters
This disease often flies under the radar. Many patients are treated with blood pressure medications without ever identifying the real problem: a hormonal imbalance. Primary aldosteronism is responsible for up to 10% of all cases of high blood pressure, and studies show that it’s the leading cause of secondary hypertension.
Adrenal tumor producing excess aldosterone—often curable with surgery.
Key Symptoms of Primary Aldosteronism
Many patients with primary aldosteronism do not exhibit symptoms that clearly point to adrenal disease. Still, some signs may include:
- Resistant or difficult-to-control high blood pressure
- Low blood potassium levels (but not always)
- Muscle cramps or weakness
- Headaches, anxiety, or heart palpitations
- Fatigue and frequent urination
Importantly, many of these symptoms are non-specific, and the condition can be missed without proper testing.
Who Should Be Tested?
You should be screened for primary aldosteronism if you have high blood pressure and any of the following:
- Low potassium levels
- Hypertension that requires more than one medication
- Family history of adrenal tumors or early-onset hypertension
- Hypertension with an adrenal mass discovered on imaging
How Primary Aldosteronism Is Diagnosed
Diagnosis typically involves checking the aldosterone-renin ratio (ARR), followed by imaging tests like a CT scan of the adrenal glands. In some cases, adrenal vein sampling (AVS) is needed to determine whether one or both glands are involved.
Treatment Options and Cure
If the condition is due to a tumor on one adrenal gland, surgery (usually a mini back scope adrenalectomy) can cure the disease. If both glands are overactive, medication or staged partial adrenal surgeries may help manage the condition. Patients who undergo adrenalectomy often experience rapid improvements in blood pressure and overall health.