16448 Hyperaldosteronism

Overview

Hyperaldosteronism happens when the adrenal glands (two small glands on top of your kidneys) make too much aldosterone. Aldosterone is a hormone that helps control your blood pressure and the balance of salt and potassium in your body. When there is too much of it, your body holds onto salt and loses potassium, which can raise your blood pressure and cause other health problems.

Some experts believe hyperaldosteronism may affect up to 1 in 10 people with high blood pressure, though it is often underdiagnosed.

It can affect anyone, but it is most often found in adults between 30 and 60 years old. It is slightly more common in women, and it can also run in families.

Symptoms

Common symptoms

• High blood pressure, especially if it does not go down with usual treatments
• Low potassium levels, which can cause muscle weakness or cramps
• Frequent urination, especially at night
• Excessive thirst
• Headaches
• Tingling or numbness in your hands or feet

Symptoms in children

• Unusually high blood pressure for a child's age
• Weakness or tiredness
• Poor growth or weight gain

Symptoms in older adults

• Symptoms can be less clear and may be mistaken as normal signs of aging
• High blood pressure that is harder to control
• Muscle weakness or falls caused by low potassium
• Confusion or feeling unusually tired

Causes

Main causes

• A non-cancerous lump (called an adenoma) in one adrenal gland produces too much aldosterone – this is the most common cause.
• Both adrenal glands are overactive, a condition called bilateral adrenal hyperplasia.
• In rare cases, an inherited (genetic) problem causes the adrenal glands to make too much aldosterone.

Risk factors

• Age between 30 and 60
• High blood pressure that is severe or resistant to several medications
• Low potassium levels in the blood
• A family history of hyperaldosteronism or early high blood pressure

When to see a doctor

See a doctor urgently if:

• If you have chest pain, difficulty breathing, fainting, or a very fast or irregular heartbeat, call your local emergency number right away.
• If you have sudden severe weakness that makes it hard to move your arms or legs, seek urgent care.

Book a routine appointment if:

• If you have high blood pressure that is not well controlled, especially if you also have low potassium
• If you have constant muscle cramps, weakness, or unusual tiredness
• If you notice you are urinating a lot or feeling thirsty often

Diagnosis

Your doctor will review your symptoms and risk factors. A simple blood test can check your potassium level and the relationship between aldosterone and another hormone called renin. Imaging scans may also be used to look for a nodule on your adrenal glands.

Tests that may be done

• Blood tests to measure aldosterone and renin levels
• Blood test for potassium level
• A CT scan or MRI of your adrenal glands
• Sometimes a procedure called adrenal vein sampling, which compares hormone levels coming from each adrenal gland

What to expect at your appointment

You may need to see a specialist, such as an endocrinologist or a hypertension specialist. Some medications for blood pressure may need to be temporarily adjusted before testing. The tests are done to confirm whether too much aldosterone is present and where the extra hormone is coming from.

Treatment

Treatment depends on the cause. If a single non-cancerous lump is found, surgery may be an option. If both glands are overactive, medicines are used to block the effect of aldosterone. The goal is to lower blood pressure and protect your heart and kidneys.

Self-care at home

• Take your prescribed medicines exactly as directed, even if you feel well.
• Monitor your blood pressure at home and keep a log to share with your doctor.
• Avoid over-the-counter supplements or salt substitutes without checking with your doctor, as they can affect potassium.

Medical treatments

Your doctor may prescribe medicines that block aldosterone. These help your body get rid of extra salt and keep potassium in your body. You may also need potassium supplements if levels are very low. Treatment is usually long-term and tailored to your specific situation.

When is surgery considered?

If a non-cancerous lump in one adrenal gland is causing the problem, surgery to remove that gland (called adrenalectomy) may be recommended. Recovery is usually quick, and many people see improvement in blood pressure after surgery.

Living with this condition

Hyperaldosteronism is a long-term condition for most people. You will need regular appointments and blood tests to check your blood pressure, potassium, and kidney function. Staying consistent with your treatment plan makes a big difference.

Lifestyle tips

• Limit salt in your diet, as salt increases the effects of aldosterone.
• Stay active with activities you enjoy, like walking, swimming, or cycling.
• Keep a steady daily routine for your medicines and meals.
• Keep your alcohol intake low, as it can affect blood pressure.

Diet and exercise

A heart-healthy diet is important. This means eating plenty of vegetables, fruits, whole grains, and lean proteins, and avoiding processed and salty foods. Regular exercise, even moderate walking, helps lower blood pressure. Always talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Living with a hormonal condition can be stressful. It is normal to feel anxious or frustrated, especially while tests are being done. Take time to talk about your feelings with someone you trust, and let your doctor know if you are feeling overwhelmed.

Prevention

Most cases of hyperaldosteronism cannot be prevented, because they are caused by a nodule or an inherited tendency. However, treating it early and controlling blood pressure can prevent many of the complications.

Complications

If left untreated

• Heart attack and stroke risk increases due to long-term high blood pressure
• Kidney damage or kidney failure
• Heart rhythm problems from low potassium
• Osteoporosis or bone weakness over time

Long-term outlook

With proper diagnosis and treatment, blood pressure often becomes easier to control, and potassium levels usually return to normal. Many people feel better and have fewer symptoms within a few weeks of starting treatment. Long-term outlook is good, especially when the condition is caught early.

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