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Hyperaldosteronism - primary and secondary
Definition
Primary and secondary hyperaldosteronism are conditions in which the adrenal gland releases too much of the hormone aldosterone.
Alternative Names
Conn syndrome
Causes
People with primary hyperaldosteronism have a problem with the adrenal gland that causes it to release too much aldosterone.
In secondary hyperaldosteronism, the excess aldosterone is caused by something outside the adrenal gland that mimics the primary condition.
Primary hyperaldosteronism used to be considered a rare condition, but some experts believe that it may be the cause of high blood pressure in some patients. Most cases of primary hyperaldosteronism are caused by a noncancerous (benign) tumor of the adrenal gland. The condition is most common in people ages 30 - 50.
Secondary hyperaldosteronism is usually due to high blood pressure. It is also related to disorders such as:
- Cirrhosis of the liver
- Heart failure
- Nephrotic syndrome
Symptoms
- Fatigue
- Headache
- Muscle weakness
- Numbness
- Paralysis that comes and goes
Exams and Tests
- Abdominal CT scan
- ECG
- Plasma aldosterone level
- Plasma renin activity
- Serum potassium level
- Urinary aldosterone
Sometimes the health care provider needs to insert a catheter into the veins of the adrenal glands to determine which of the adrenals contains the growth.
This disease may also affect the results of the following tests:
Treatment
Primary hyperaldosteronism caused by a tumor is usually treated with surgery. Removing adrenal tumors may control the symptoms. Even after surgery, some people still have high blood pressure and need to take medication. However, they can often reduce the number of medications or doses they take.
Watching how much salt you eat and taking medication may control the symptoms without surgery. Medications used to treat hyperaldosteronism include:
- Amiloride
- Spironolactone (Aldactone; Aldactazide), a diuretic ("water pill")
- Triamterene
Medicines and diet (but not surgery) are used to treat secondary hyperaldosteronism.
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
Impotence and gynecomastia (enlarged breasts in men) may occur with long-term spironolactone treatment in men, but this is uncommon.
When to Contact a Medical Professional
Call for an appointment with your health care provider if you develop symptoms of hyperaldosteronism.
References
Young WF Jr. Endocrine hypertension. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 16.
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
