Primary hyperaldosteronism is a syndrome associated with increased secretion of the hormone aldosterone by the adrenal gland. This increased secretion is caused by an abnormality within the gland.

In secondary hyperaldosteronism, the increased production of 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 0.5% to 14% of patients. Most cases of primary hyperaldosteronism result from a benign tumor of the adrenal gland, and occur in people between the ages of 30 and 50 years old.

The excess aldosterone secreted in this condition increases sodium reabsorption and potassium loss by the kidneys. The result is an electrolyte imbalance.

Secondary hyperaldosteronism is generally related to hypertension (high blood pressure). It is also related to disorders such as cardiac failure, cirrhosis of the liver, and nephrotic (kidney) syndrome. In these disorders, various mechanisms from the individual disease cause the level of the hormone to be elevated.

• High blood pressure
• Headache
• Muscle weakness
• Fatigue
• Intermittent paralysis 
• Numbness 

• Low serum potassium level
• Abdominal CT scan that shows adrenal mass
• Elevated plasma aldosterone level
• Elevated urinary aldosterone
• Low plasma renin activity
• ECG that shows heart rhythm abnormalities associated with low potassium levels

• Urine sodium
• Serum sodium
• Urine potassium
• Serum magnesium test
• CO2

Primary hyperaldosteronism resulting from an adenoma (tumor) is usually treated surgically. Removal of adrenal tumors may control the symptoms. Even after surgery, some people have elevated blood pressure and require medication.

Dietary sodium restriction and administration of medication may control the symptoms without surgery. Medications used to treat hyperaldosteronism are the diuretic ("water pill") spironolactone (Aldactone; Aldactazide) or eplerenone (Inspra), which blocks aldosterone action.

In secondary hyperaldosteronism, there is no surgical intervention, but medications and diet will be included in the patient's treatment.

The prognosis for primary hyperaldosteronism is good with early diagnosis and treatment. The prognosis for secondary hyperaldosteronism will vary depending on the cause of the condition.

Impotence and gynecomastia (enlarged breasts in men) may be associated with long-term treatment in men.

Call for an appointment with your health care provider if symptoms of hyperaldosteronism develop.