Primary aldosteronism, also termed Conn syndrome. This increased secretion is caused by an abnormality within the gland. Primary hyperaldosteronism accounts for less than one percent of all cases of hypertension. The adrenal glands are orange-colored endocrine glands that are located on the top of both kidneys. The adrenal glands are triangular shaped and measure about one-half inch in height and three inches in length. Sometimes hyperaldosteronism is a response to certain diseases, such as very high blood pressure (hypertension). High aldosterone levels can lead to low potassium levels. Low potassium levels often produce no symptoms but may lead to weakness, tingling, muscle spasms, and periods of temporary paralysis. PH occurs worldwide. This appears particularly true of the IAH variant of the disease. It is more common in females than males.
Hyperaldosteronism can occur at any age, but most commonly when a person is in their 30s and 40s. Secondary hyperaldosteronism is generally related to hypertension (high blood pressure). It is also related to disorders such as cardiac failure, cirrhosis of the liver, and nephrotic (kidney) syndrome. In these disorders, various mechanisms from the individual disease cause the level of the hormone to be elevated. A renin producing tumour leads to increased aldosterone, as the body’s aldosterone production is normally regulated by renin levels. A neonatal idiopathic form of hyperaldosteronism has been described that presents with functional gastrointestinal tract symptoms associated with hypokalemia and hypertension. Constipation, muscle weakness (sometimes to the point of periodic paralysis), excessive urination, excessive thirst, headache, and personality changes are also possible symptoms. Some patients will show no obvious symptoms. There are several causes for this condition, including primary adrenal insufficiency, congenital adrenal hyperplasia, and medications.
Primary hyperaldosteronism resulting from an adenoma (tumor) is usually treated surgically. Medications used to treat hyperaldosteronism are the diuretic (“water pill”) spironolactone (Aldactone; Aldactazide) or eplerenone (Inspra), which blocks aldosterone action. Medical therapy is also a viable treatment option in patients who have lateralizable disease. It is also a viable treatment option in the rare setting of bilateral functional adrenal adenomas that would otherwise require bilateral adrenalectomy. GRA is treated with small doses of glucocorticosteroids (ie, hydrocortisone, prednisone). At optimal doses, glucocorticosteroids normalize aldosterone and blood pressure. Various antihypertensives may be added to achieve adequate blood pressure control. Spironolactone can usually control the symptoms, and drugs for high blood pressure are readily available. Blood pressure elevation needs to be controlled and monitored by frequent blood pressure measurements.
