Hyperaldosteronism - primary and secondary
Hyperaldosteronism can be primary or secondary.
Conn syndrome; Mineralocorticoid excess
Primary hyperaldosteronism is due to a problem of the adrenal glands themselves, causing them to release too much aldosterone. In contrast, with secondary hyperaldosteronism, the adrenal glands release too much aldosterone as a result of a problem elsewhere in the body. These problems can be with genes, diet, or a medical disorder such as with the heart, liver, kidneys, or high blood pressure.
Most cases of primary hyperaldosteronism are caused by a noncancerous (benign) tumor of the adrenal gland. The condition is most common in people 30 to 50 years old.
Primary and secondary hyperaldosteronism have common symptoms, including:
Exams and Tests
Tests that may be ordered to diagnose hyperaldosteronism include:
- Abdominal CT scan
- Plasma aldosterone level
- Plasma renin activity
- Serum potassium level
- Urinary aldosterone
A procedure to insert a catheter into the veins of the adrenal glands may need to be done. This helps check which of the two adrenal glands is making too much aldosterone.
This disease may also affect the results of the following tests:
Primary hyperaldosteronism caused by an adrenal gland tumor is usually treated with surgery. It can sometimes be treated with medicines. Removing the adrenal tumor may control the symptoms. Even after surgery, some people still have high blood pressure and need to take medicine. But often, the number of medicines or doses can be lowered.
Limiting how much salt intake and taking medicine may control the symptoms without surgery. Medicines to treat hyperaldosteronism include:
- Drugs that block the action of aldosterone
- Diuretics (water pills), which help manage fluid buildup in the body
Secondary hyperaldosteronism is treated with medicines (as described above) and limiting salt intake. Surgery is not used.
The outlook for primary hyperaldosteronism is good with early diagnosis and treatment.
The outlook for secondary hyperaldosteronism depends on the cause of the condition.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you develop symptoms of hyperaldosteronism.
Ioachimescu AG, Hamrahian AH. Diseases of the adrenal gland. In: Cleveland Clinic: Current Clinical Medicine. 2nd ed. Elsevier Saunders; 2010:sec 4.
Nieman LK. Adrenal cortex. In: In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 234.
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.