Primary Hyperaldosteronism

Primary Hyperaldosteronism

Diseases & Conditions
Cancer & Benign Tumors
Contributed byMaulik P. Purohit MD MPHJan 01, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Conn Syndrome
  • Primary Aldosteronism

What is Primary Hyperaldosteronism? (Definition/Background Information)

  • Hyperaldosteronism is a condition in which the adrenal gland releases too much of the hormone called aldosterone. The normal function of aldosterone is to maintain adequate levels of potassium and sodium in blood and also to regulate the blood pressure
  • When too much of this hormone is produced, fluid levels increase in the body due to the excess loss of potassium and retention of sodium. The increased fluid levels result in a higher blood pressure
  • When this condition is caused due to a disorder of the adrenal gland itself, it is referred to as Primary Hyperaldosteronism
  • Primary Hyperaldosteronism is most common in young and middle-aged adults and is typically caused by either a benign tumor of the gland, or due to an overactive gland
  • The condition results in signs and symptoms such as muscle weakness, blurring of vision, and high blood pressure. Primary Hyperaldosteronism could result in complications that include cardiac arrhythmias and heart attack, stroke, or kidney damage from chronic high blood pressures
  • There is no effective prevention of Primary Hyperaldosteronism available, but it may be treated through a surgical removal of the tumor and administration of medications, in case of an enlarged, overactive adrenal gland
  • The prognosis of Primary Hyperaldosteronism is good with early detection and treatment of the condition

Who gets Primary Hyperaldosteronism? (Age and Sex Distribution)

  • Primary Hyperaldosteronism is most common in individuals between the ages of 30 and 50 years
  • It has shown a higher prevalence among women than men
  • The condition is observed worldwide; all racial and ethnic groups are at risk

What are the Risk Factors for Primary Hyperaldosteronism? (Predisposing Factors)

  • There are no specific risk factors associated with the development of Primary Hyperaldosteronism

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Primary Hyperaldosteronism? (Etiology)

Common causes of Primary Hyperaldosteronism include:

  • Benign tumor of the adrenal gland: This tumor is termed as an “aldosteronoma” and is responsible for the overproduction of the hormone aldosterone
  • Bilateral adrenal gland hyperplasia: This occurs when both glands produce excessive quantities of hormone
  • Unilateral hyperplasia of the gland: This condition occurs when only one of the glands is hyperactive

Other rare causes of the condition include:

  • Various genetic syndromes that result in excessive aldosterone levels
  • Malignant (cancerous) aldosterone-producing tumor
  • 10% of the individuals diagnosed with high blood pressure are noted to have Primary Hyperaldosteronism

What are the Signs and Symptoms of Primary Hyperaldosteronism?

The signs and symptoms of Primary Hyperaldosteronism may include:

  • Muscle weakness and muscle paralysis
  • Hypokalemia: Abnormally low levels of potassium in blood
  • Fatigue
  • Blurred vision
  • High blood pressure (that does not decrease in response to medication)
  • Excessive thirst

How is Primary Hyperaldosteronism Diagnosed?

The diagnosis of Primary Hyperaldosteronism involves a complete evaluation of one’s medical history and a thorough physical exam. The tests and procedures conducted may include:

  • CT scan of the abdomen
  • Urinary aldosterone level
  • Plasma aldosterone level
  • ECG to check electrical activity of the heart, because abnormally low levels of potassium affect the heart rhythm
  • Nuclear scanning
  • Serum potassium and electrolyte level
  • Insertion of catheter into the adrenal gland veins to check the levels of aldosterone (in the vein)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Primary Hyperaldosteronism?

The complications of Primary Hyperaldosteronism could include:

  • Low potassium levels may affect the electrical activity of the heart resulting in cardiac arrhythmias
  • Muscle cramps and weakness due to low potassium levels
  • Persistently high blood pressure may lead to the following complications:
    • Kidney damage
    • Heart attack
    • Heart failure
    • Stroke         

How is Primary Hyperaldosteronism Treated?

The treatment of hyperaldosteronism is dependent upon the underlying cause.

  • Individuals who have Primary Hyperaldosteronism as a result of bilateral hyperplasia are treated with medications to stabilize the potassium and sodium levels in blood. Blood pressure is also controlled using medications
  • In addition to medication, a diet with low salt is generally recommended. Eating a low salt diet may eliminate the necessity of surgery in some cases
  • Those with unilateral hyperplasia may be recommended an adrenalectomy (removal of the adrenal gland by surgery)
  • Common medications given for hyperaldosteronism include:
    • Diuretic (water pills)
    • Amiloride
    • Aldactone
    • Aldactazide
    • Triamterene          
  • Individuals with tumor of the adrenal gland are usually advised to undergo surgical removal of the gland

How can Primary Hyperaldosteronism be Prevented?

Currently, there are no known measures to prevent Primary Hyperaldosteronism.

What is the Prognosis of Primary Hyperaldosteronism? (Outcomes/Resolutions)

  • The prognosis of Primary Hyperaldosteronism is good with early detection and treatment of the condition
  • Most affected individuals are typically able to lead a normal life

Additional and Relevant Useful Information for Primary Hyperaldosteronism:

When excess amounts of aldosterone are released due to factors outside of the adrenal gland, it is referred to as secondary hyperaldosteronism.

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team


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