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Hyperaldosteronism - primary and secondary

  • Definition
    • Hyperaldosteronism is a disorder in which the adrenal gland releases too much of the hormone aldosterone into the blood.

      Hyperaldosteronism can be primary or secondary.

  • Alternative Names
    • Conn syndrome; Mineralocorticoid excess

  • 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 is most common in people 30 to 50 years old.

  • Symptoms
  • Exams and Tests
  • 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.

      Limiting 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 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.

      Impotence and gynecomastia (enlarged breasts in men) may occur with long-term use of medicines. 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
    • 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; 2015:chap 108.

      Nieman LK. Adrenal cortex. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 227.