What is primary hyperaldosteronism?

Primary hyperaldosteronism is an endocrine disorder due to hypersecretion of aldosterone, leading to hypertension.


How common is it?

More than 10% of patients with hypertension have primary hyperaldosteronism.


What are the causes of primary hyperaldosteronism?

  • Aldosterinoma (adrenal adenoma (tumour) that over-secretes aldosterone)
  • Unilateral or bilateral adrenal hyperplasia
  • Familial Hyperaldosteronism
  • Adrenal or non-adrenal cancer that secretes aldosterone.

What are the symptoms and signs of primary hyperaldosteronism?

  • Muscle cramps
  • Weakness
  • Fatigue
  • Intense thirst
  • Frequent urination
  • Headaches
  • Resistant Hypertension: difficult to control
  • Hypokalemia

Νεφρά επινεφρίδια - Σύνδρομο Cushing - πρωτοπαθής υπεραλδοστερονισμός

What are the complications of primary hyperaldosteronism?

  • Cerebrovascular accident
  • Heart failure or cardiac arrest
  • Atrial fibrillation, Arrhythmia
  • Myocardial infarction
  • Increased cardiovascular risk
  • Muscle weakness
  • Kidney failure
  • Electrolyte abnormalities

How is primary hyperaldosteronism diagnosed?

The initial diagnosis is made through history, physical examination and hormonal tests. If the results are positive, the diagnosis needs to be confirmed by means of specialized endocrine tests. Investigation of the cause involves imaging studies and usually requires adrenal vein catheterization. All the above are necessary for a proper treatment and require a multidisciplinary team with specialized knowledge and experience, as well as, a specialized (tertiary) centre.


How is primary hyperaldosteronism treated?

Treatment depends on the cause, comorbidities, age and patient preference. In the case of adenoma (adrenal tumour), surgical removal of the adrenal gland laparoscopically is recommended. In case of contraindications or patient preference, treatment includes medications that ‘block’ the effects of aldosterone. If hyperaldosteronism is due to hyperactivity of both adrenal glands, then drug therapy is recommended.