What Is Hyperaldosteronism?

Hyperaldosteronism is a condition in which the adrenal glands produce too much aldosterone, a hormone that helps regulate blood pressure and the balance of sodium and potassium in the body. Excess aldosterone leads to sodium retention, potassium loss, and increased blood pressure.

There are two main types:

• Primary hyperaldosteronism (Conn’s syndrome): Caused by a problem in the adrenal glands themselves.
• Secondary hyperaldosteronism: Caused by external factors such as kidney disease or heart failure that trigger overproduction of aldosterone.

What Causes Hyperaldosteronism?

Primary hyperaldosteronism is usually caused by:

• A noncancerous tumor on the adrenal gland (aldosterone-producing adenoma)
• Overactivity in both adrenal glands (bilateral adrenal hyperplasia)

Secondary hyperaldosteronism can result from:

• Chronic kidney disease
• Heart failure
• Liver cirrhosis
• Dehydration
• Certain medications (like diuretics)

What Are the Symptoms?

Many people with hyperaldosteronism have no symptoms at first, but common signs may include:

• High blood pressure (often resistant to treatment)
• Muscle weakness
• Fatigue
• Headaches
• Frequent urination
• Increased thirst
• Low potassium levels (hypokalemia)

How Is It Diagnosed?

Diagnosis usually begins with a review of symptoms and blood pressure history. Common tests include:

• Blood tests to measure aldosterone and renin levels
• Electrolyte panels (especially potassium levels)
• Aldosterone-renin ratio (ARR)
• CT scan or MRI of the adrenal glands
• Adrenal vein sampling in some cases to pinpoint the source

What Is the Treatment?

Treatment depends on the underlying cause:

For primary hyperaldosteronism:

• Surgical removal of the adrenal tumor if only one gland is affected
• Medications such as aldosterone blockers (e.g., spironolactone or eplerenone) if both glands are involved

For secondary hyperaldosteronism:

• Treating the underlying condition (e.g., improving heart or kidney function)
• Using medications to control blood pressure and correct potassium levels

Are There Any Complications?

If left untreated, hyperaldosteronism can lead to:

• Severe or uncontrolled high blood pressure
• Stroke
• Heart attack
• Heart failure
• Kidney damage
• Persistent low potassium levels

What Is the Outlook?

With early diagnosis and appropriate treatment, the outlook for hyperaldosteronism is generally good. Blood pressure and potassium levels often improve significantly, and long-term complications can be prevented.

Can Hyperaldosteronism Be Prevented?

There is no guaranteed way to prevent hyperaldosteronism, but managing risk factors like high blood pressure and regular check-ups for individuals with adrenal or kidney issues can help with early detection.