Hyperaldosteronism

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Overview

Hyperaldosteronism is an endocrine disorder characterized by the excessive production of aldosterone by the adrenal glands. Hyperaldosteronism may be primary or secondary. In primary hyperaldosteronism, which is due to an abnormality within the adrenal gland, the initiating event is an autonomous increase in the secretion of aldosterone. Secondary hyperaldosteronism is initiated by activation of the renin-angiotensin system, which, in turn, increases the secretion of aldosterone. Thus, in secondary hyperaldosteronism, the increased production of aldosterone by the adrenal gland is due to an external (extra-adrenal) stimulus.

Symptoms

The main symptom of hyperaldosteronism is high blood pressure, which can range from moderate to severe. In some cases, high blood pressure related to hyperaldosteronism doesn’t respond to medication. In others, it may only respond to a certain combination of medications.


High blood pressure doesn’t typically have symptoms. But when it does, they can include:


headaches

dizziness

vision problems

chest pain

shortness of breath

The other main symptom of hyperaldosteronism is hypokalemia, which refers to low potassium levels in your blood. While it doesn’t always cause symptoms, more moderate cases of hypokalemia may cause:


fatigue

muscle cramps

increased thirst

increased urination

muscle weakness

palpitations

Causes

Hyperaldosteronism occurs when the adrenal glands release too much aldosterone.


Primary hyperaldosteronism is due to a problem of the adrenal glands themselves. Most cases are caused by a noncancerous (benign) tumor of the adrenal gland.


Secondary hyperaldosteronism is due to a problem elsewhere in the body that causes the adrenal glands to release too much aldosterone. These problems can be with:


Genes

Diet

Medical disorders such as with the heart, liver, kidneys, or high blood pressure

The condition mostly affects people 30 to 50 years old and is a common cause of high blood pressure in middle age.


Risk factors

The result is an electrolyte imbalance. 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.

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Complications

rhabdomyolysis has also been seen as a complication of severe hypokalemia, complicating primary hyperaldosteronism in the absence of exercise. Abnormalities of renal function often accompany acute or chronic hypokalemia. These may include nephrogenic diabetes insipidus

Prevention

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.