What Disease Is Caused by Excess Aldosterone (hyperaldosteronism)?

How Excess Aldosterone Affects Your Body

Did you know that a hidden hormone imbalance could be silently driving your high blood pressure? Aldosterone, which is produced by the adrenal glands, regulates salt and water in the body. However, when the body produces too much aldosterone, it can result in a condition called aldosteronism. Shockingly, a 2020 study found it in over 20% of patients with resistant hypertension.
 

So, could this be the missing link in your health puzzle? Keep reading to know all the details.

How does primary aldosteronism affect the body?

In primary aldosteronism, also known as Conn’s syndrome, excess aldosterone causes the body to retain sodium and water. This increases blood volume, thereby raising blood pressure. At the same time, the body loses excessive potassium, which can result in various symptoms.
 

There are multiple underlying causes of this condition:

• A small, non-cancerous tumour (aldosterone-producing adenoma) on one adrenal gland.
• Unilateral adrenal hyperplasia, where one gland becomes enlarged.
• Rare genetic conditions where the disease runs in families, such as familial hyperaldosteronism.

Who Can Get Primary Aldosteronism?

People between the ages of 30 and 50 are more commonly affected, and women may have a slightly increased risk. It is estimated that 5–10% of people with hypertension may have undiagnosed primary aldosteronism. It is particularly prevalent in those whose blood pressure does not improve with standard antihypertensive medicines.

What is secondary aldosteronism?

In secondary aldosteronism, elevated aldosterone levels occur as a response to another underlying health condition rather than a problem within the adrenal glands themselves.

Conditions that can trigger this include:

• Oedema from congestive heart failure
• Liver cirrhosis
• Nephrotic syndrome
• Renovascular hypertension
   

In secondary aldosteronism, the adrenal glands produce excess aldosterone as an appropriate response to another medical condition. This is typically driven by high levels of renin, a kidney enzyme. The elevated aldosterone is a symptom of the underlying problem, not the primary cause.

What are the Signs and Risks?

The most common sign of aldosteronism is resistant hypertension, which is high blood pressure that does not respond well to standard treatment. Additional symptoms can occur, particularly if the condition leads to low potassium levels (hypokalemia). These may include.

• Muscle weakness
• Fatigue
• Frequent urination
• Headaches
   

If left untreated, aldosteronism can lead to severe complications such as:

• Stroke
• Heart attack
• Arrhythmias (irregular heartbeats)
• Kidney damage
• In rare cases, temporary paralysis due to hypokalaemia

How is Aldosteronism Diagnosed?

The typical diagnosis of this condition includes:

• Measuring blood levels of aldosterone and renin.
• A high aldosterone-to-renin ratio (ARR) suggests primary aldosteronism.
• Confirmatory tests like the saline infusion test, captopril challenge test, or oral sodium loading test.
   

Imaging techniques such as CT or MRI scans help detect adrenal gland abnormalities. In certain cases, adrenal vein sampling is performed to distinguish if one or both adrenal glands are affected.

What Treatments Are Available?

Some of the treatment options, depending on the underlying cause, are as follows:

• Laparoscopic adrenalectomy (surgical removal of one adrenal gland) is often curative for unilateral adenomas.
• For bilateral disease or patients unfit for surgery, aldosterone antagonists such as spironolactone or eplerenone are used to block aldosterone’s effects.
   

Dietary and lifestyle recommendations include:

• Reducing salt intake
• Maintaining a healthy weight
• Regular physical activity
   

These steps support blood pressure control, along with medication or surgery. Lifestyle changes can help control blood pressure and prevent serious complications.

Aldosteronism often goes undetected, yet it can be a key contributor to resistant high blood pressure. Early diagnosis and treatment with the help of medication, surgery, and lifestyle changes can significantly improve health outcomes. If your hypertension is not responding to standard care, exploring aldosterone levels might reveal a crucial piece of your health puzzle.

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