Hyperaldosteronism
More than 172 million people in the US, or half of the population, have hypertension or high blood pressure. Studies show about 20% of those people, or more than 34 million, have elevated aldosterone or hyperaldosteronism. Aldosterone is a hormone that helps regulate blood pressure by controlling the levels of potassium and sodium in your blood.
Experts say hyperaldosteronism is much more common than previously thought and there is likely a genetic component that predisposes some people to develop the condition. Familial cases are documented, but at this point the genetic component is not well defined.
Nevertheless, knowing whether you have hyperaldosteronism is important because high blood pressure, or hypertension, is a major risk factor in 50% of all strokes, 70% of hemorrhagic strokes, 50% of cardiovascular disease-related deaths, 15% to 20% of Alzheimer’s disease cases and 28% of chronic kidney disease cases.
What is hyperaldosteronism?
Hyperaldosteronism is a treatable condition that occurs when one or both of your adrenal glands produce too much of the hormone aldosterone. This causes high blood pressure, also known as hypertension, and low potassium levels in your blood.
Aldosterone helps regulate blood pressure by controlling the levels of potassium and sodium in your blood. It is secreted by the adrenal glands, which are located on each of your kidneys. Left untreated, hyperaldosteronism can lead to serious health complications, including heart attacks, heart failure, stroke and kidney failure.
There are 2 types of hyperaldosteronism:
Primary hyperaldosteronism results from overproduction of the hormone aldosterone, which regulates sodium and potassium levels in your blood. Primary hyperaldosteronism can be unilateral or bilateral. Unilateral hyperaldosteronism is where one adrenal gland overproduces aldosterone, and bilateral hyperaldosteronism refers to the overproduction of aldosterone by both adrenal glands. We typically treat this condition with medications and lifestyle changes to manage blood pressure. Some cases of primary hyperaldosteronism may require surgery (for example, to remove a nodule(s) on the adrenal gland that is producing excess aldosterone). Adrenal noncancerous tumors are the most common cause of primary hyperaldosteronism.
Secondary hyperaldosteronism is caused by reduced blood flow to your kidneys. This differs from primary hyperaldosteronism, which is caused by a problem within the adrenal glands. In secondary hyperaldosteronism, the excessive aldosterone production is often triggered by decreased blood flow to the kidneys caused by renal artery disease, congestive heart failure, liver cirrhosis or other conditions.
Hyperaldosteronism symptoms and risks
Symptoms of hyperaldosteronism vary based on the severity of the condition. Some people have mild cases of hyperaldosteronism and show no symptoms. The most common symptom is high blood pressure, or hypertension, especially if your hypertension is resistant to treatment with medication.
Other symptoms you may experience, either because of high blood pressure and/or low potassium levels, include:
- Dizziness
- Difficulty breathing
- Extreme thirst
- Fatigue
- Frequent urination
- Headache
- Muscle numbness and/or weakness
- Vision changes
Nothing can prevent primary hyperaldosteronism, but if it’s diagnosed and treated early the prognosis is good. The outlook for secondary hyperaldosteronism depends on the cause of the condition. Cardiovascular issues caused by high blood pressure are the most common complications of hyperaldosteronism and include:
- Atrial fibrillation
- Heart attack
- Left ventricular hypertrophy
- Stroke
Hyperaldosteronism diagnosis and screening
We use blood tests to diagnose hyperaldosteronism. Common indicators include high blood pressure that does not respond to medication or that requires multiple medications to control and elevated sodium and low potassium levels in your blood.
If we suspect you have hyperaldosteronism based on these indicators and your symptoms, we will order additional blood tests: plasma renin concentration (PRC) or plasma renin activity (PRA). If your PRC and PRA levels are lower than normal, you have primary hyperaldosteronism. If your PRC and PRA levels are higher than normal, you have secondary hyperaldosteronism.
We may also order an aldosterone suppression test. For this test, you consume sodium orally or through an IV over a specified time and provide urine samples over 24 hours. We measure the amount of aldosterone in your urine.
If these tests confirm you have hyperaldosteronism, we may order imaging tests, such as a computed tomography (CT) scan, to determine whether a tumor on your adrenal gland could be causing your hyperaldosteronism.
If you take multiple medications for uncontrolled high blood pressure, you can also request to be tested for hyperaldosteronism.
Hyperaldosteronism treatment
Treatment for hyperaldosteronism varies based on the type you have and its underlying cause.
For primary hyperaldosteronism caused by a unilateral adrenal gland tumor, we may recommend surgical treatment. Surgery can be done laparoscopically, allowing for a speedy recovery. If the condition is bilateral or if surgery isn’t an option, we may use medications to block the effects of aldosterone.
With secondary hyperaldosteronism, we address the condition’s underlying cause, which may involve medications or other therapies. Other forms of treatment include:
- Medications to block the action of aldosterone when surgery is not feasible
- A low-sodium diet to help manage blood pressure
- DASH diet (Dietary Approaches to Stop Hypertension), a researched and proven diet for lowering blood pressure that is frequently recommended for patients with primary aldosteronism
- Regular exercise to help lower blood pressure
- Limiting or avoiding alcohol and caffeine, which can raise blood pressure
- Stop smoking, as smoking constricts blood vessels and can increase blood pressure
Why choose us for hyperaldosteronism treatment
The University of Kansas Health System is a leader in the prevention and treatment of hypertension, including that caused by hyperaldosteronism. Our experienced physicians, leading-edge technologies and exceptional facilities are some of the reasons why our outcomes are among the best in the country.
- Our partners at the University of Kansas Medical Center are recognized for innovative research on hypertension and kidney disease, while the health system is known for its excellence in quality patient care.
- We participate in a variety of clinical trials and studies to improve hypertension prevention and treatment.