Primary and secondary hyperaldosteronism
Conn syndrome; Mineralocorticoid excessHyperaldosteronism is a disorder in which the adrenal gland releases too much of the hormone aldosterone into the blood.
Adrenal gland
The adrenal glands are two small triangle-shaped glands. One gland is located on top of each kidney.
Aldosterone
The aldosterone blood test measures the level of the hormone aldosterone in blood. Aldosterone can also be measured using a urine test.
Read Article Now Book Mark ArticleHyperaldosteronism can be primary or secondary.
Causes
Primary hyperaldosteronism is due to a problem of the adrenal glands themselves, which causes them to release too much aldosterone.
In contrast, with secondary hyperaldosteronism, a problem elsewhere in the body causes the adrenal glands to release too much aldosterone. 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 mostly affects people 30 to 50 years old and is a common cause of high blood pressure in middle age.
Symptoms
Primary and secondary hyperaldosteronism have common symptoms, including:
- High blood pressure
- Low level of potassium in the blood
- Feeling tired all the time
- Headache
- Muscle weakness
- Numbness
Exams and Tests
The health care provider will perform a physical exam and ask about your symptoms.
Tests that may be ordered to diagnose hyperaldosteronism include:
- Abdominal CT scan
Abdominal CT scan
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
ImageRead Article Now Book Mark Article - ECG
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
ImageRead Article Now Book Mark Article - Blood aldosterone level
Blood aldosterone
The aldosterone blood test measures the level of the hormone aldosterone in blood. Aldosterone can also be measured using a urine test.
Read Article Now Book Mark Article - Blood renin activity
Blood renin activity
The renin test measures the level of renin in blood.
ImageRead Article Now Book Mark Article - Blood potassium level
Blood potassium
This test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also ...
ImageRead Article Now Book Mark Article - Urinary aldosterone
Urinary aldosterone
The 24-hour urinary aldosterone excretion test measures the amount of aldosterone removed in the urine in a day. Aldosterone can also be measured wit...
Read Article Now Book Mark Article - Kidney ultrasound
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 test is important because many people have small benign tumors in the adrenal glands that do not secrete any hormones. Relying only on a CT scan may result in the wrong adrenal gland being removed.
Treatment
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.
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Read Article Now Book Mark ArticleLimiting 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 usually not used.
Outlook (Prognosis)
The outlook for primary hyperaldosteronism is good with early diagnosis and treatment.
The outlook for secondary hyperaldosteronism depends on the cause of the condition.
Possible Complications
Primary hyperaldosteronism can cause very high blood pressure, which can damage many organs, including the eyes, kidneys, heart and brain.
Erection problems and gynecomastia (enlarged breasts in men) may occur with long-term use of medicines to block the effect of hyperaldosteronism.
Erection problems
An erection problem occurs when a man cannot get or keep an erection that is firm enough for intercourse. You may not be able to get an erection at ...
Gynecomastia
When abnormally large breasts develop in males, it is called gynecomastia. It is due to the excess growth of breast tissue, not excess fat tissue....
When to Contact a Medical Professional
Call for an appointment with your provider if you develop symptoms of hyperaldosteronism.
References
Carey RM, Padia SH. Primary mineralocorticoid excess disorders and hypertension. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 108.
Nieman LK. Adrenal cortex. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 214.
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Adrenal gland hormone secretion - illustration
The adrenal gland secretes steroid hormones such as cortisol and aldosterone. It also makes precursors that can be converted to sex steroids (androgen, estrogen). A different part of the adrenal gland makes adrenaline (epinephrine). When the glands produce more or less hormones than required by the body, disease conditions may occur.
Adrenal gland hormone secretion
illustration
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Adrenal gland hormone secretion - illustration
The adrenal gland secretes steroid hormones such as cortisol and aldosterone. It also makes precursors that can be converted to sex steroids (androgen, estrogen). A different part of the adrenal gland makes adrenaline (epinephrine). When the glands produce more or less hormones than required by the body, disease conditions may occur.
Adrenal gland hormone secretion
illustration
Review Date: 7/16/2019
Reviewed By: Brent Wisse, MD, board certified in Metabolism/ Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
