Hyperaldosteronism

If you have symptoms of hyperaldosteronism, your doctor will likely start by doing a blood test to check your levels of aldosterone and renin, an enzyme released by your kidney that works with aldosterone to help balance blood pressure. People with hyperaldosteronism generally have low renin levels and high aldosterone levels.

Depending on the results of your blood test, your doctor might run some other tests, including:

Captopril challenge test. This blood test measures your aldosterone, renin, and other levels after you receive a dose of the medication captopril, an ACE inhibitor.

Saline infusion test. This blood test measures your aldosterone, renin, and other levels after you receive an IV sodium and saline solution.

Salt-loading test. This measures the levels of aldosterone and sodium in your urine after following a high-sodium diet for three to five days.

Fludrocortisone suppression test. This is very similar to the salt-loading test, but it includes taking fludrocortisone, an oral steroid that mimics aldosterone.

CT or MRI scans of the abdomen. These imaging tests allow your doctor to check for any tumors on or around your adrenal glands.

Adrenal vein sample. This involves taking a blood sample directly from the veins of each adrenal gland and testing the amount of aldosterone in it. If blood from one gland has significantly more aldosterone, you may have a benign tumor on one gland. If blood from each gland has similarly high levels of aldosterone, both glands are likely overactive.

Treating hyperaldosteronism focuses on reducing your aldosterone levels or blocking the effects of aldosterone, high blood pressure, and low blood potassium. There are several ways to do this, depending on what’s causing your hyperaldosteronism.

Medication

Your doctor might prescribe a mineralocorticoid receptor antagonist, such as spironolactone. This type of medication blocks the effects of aldosterone on your body, such as high blood pressure and low blood potassium. You may still need to take additional medications to help manage your blood pressure.

Surgery

If you have a tumor on one of your adrenal glands, your doctor may be able to remove the affected gland. Following the procedure, called an adrenalectomy, you’ll likely notice a gradual decrease in blood pressure. As you heal, your doctor will regularly monitor your blood pressure to determine whether it’s time to change your blood pressure medication. Eventually, you may be able to stop taking it completely.

Lifestyle changes

In addition to medication and surgery, there are several lifestyle changes you can make to provide additional health benefits and help counteract the effects of too much aldosterone.

These include:

Eating a healthy diet. Following a balanced diet that helps you maintain a healthy weight can reduce your blood pressure. Start by choosing fresh, unprocessed foods to reduce your salt intake. Try incorporating elements of the DASH diet, which is designed for people with high blood pressure. In addition, many blood pressure medications work better when combined with a healthy diet. A diet lower in salt is often key in hyperaldosteronism.

Exercising. Consistent exercise, even just a 30-minute walk a few times a week, can help to reduce blood pressure.

Reducing alcohol and caffeine. Caffeine and alcohol can both increase your blood pressure. Some blood pressure medications are also less effective when taken with alcohol.

Quitting smoking. Smoking cigarettes constricts your blood vessels, which increases your heart rate and can raise blood pressure. Learn about different methods that can help you kick the habit. Smoking also increases your risk of heart attack and stroke, even without high blood pressure.