What is primary hyperaldosteronism?
Primary hyperaldosteronism (PAH) is a disorder in which the adrenal gland produces too much of the hormone aldosterone in the blood. Aldosterone is a hormone involved in blood pressure control and renal water and salt metabolism. It is also known as Conn’s syndrome.
In most cases it is caused by a benign tumor of the adrenal gland. This pathology mainly affects people between 30 and 50 years old.
It can be primary or secondary hyperaldosteronism.
Prognosis of the disease
In primary hyperaldosteronism it is usually positive if a proper diagnosis and treatment is made. If not properly treated it can cause very high blood pressure, which can damage many organs. These affected organs include the eyes, heart, brain, and kidneys.
Symptoms of primary hyperaldosteronism
Most of the symptoms of primary hyperaldosteronism coincide with those of secondary hyperaldosteronism. We can appreciate the following:
- The main symptom is high blood pressure.
- Fatigue
- Low levels of potassium in the blood
- Weak muscles
- Headache
- Numbness
Fatigue is one of the symptoms of primary hyperaldosteronism.
Medical tests for primary hyperaldosteronism
After an evaluation of symptoms and a physical examination, the doctor will assess performing the following tests to diagnose primary hyperaldosteronism:
- Electrocardiogram
- CT scan of the abdomen
- Aldosterone and potassium level in the blood
- Renin activity in the blood
- Urinary aldosterone
- Ultrasound of the kidneys
What are the causes of primary hyperaldosteronism?
Primary hyperaldosteronism results from a problem in the adrenal glands, which create an excess production of aldosterone. The secretion into the bloodstream is due to the disease of one or both adrenal glands. We can distinguish two types of primary hyperaldosteronism, with their causes:
- In most cases it is caused by a benign (non-cancerous) tumor of the adrenal gland.
- Both adrenal glands are affected by hyperplasia. This process is an excessive, non-tumorous, benign proliferation of hormone-producing cells.
The causes that determine the origin of the adenoma or hyperplasia are not known. Finally, there is a very rare primary hyperaldosteronism, hyperaldosteronism remediable with glucocorticoids. It is characterized by its appearance in infantile ages and its familial aggregation. It responds positively to medical treatment, through the administration of glucocorticoids.
Can it be prevented?
It cannot be prevented directly, but it is advisable to maintain a low blood pressure. Therefore, it is important to have a healthy lifestyle:
- A balanced and healthy diet
- Adequate weight
- Exercise
- Not smoking and limiting alcohol and caffeine intake.
Treatments for primary hyperaldosteronism
Primary hyperaldosteronism in some cases can be treated with medication.
Most often it is treated with surgery, as removal of the adrenal tumor can control symptoms. Some of the patients, after surgery, may still have high blood pressure and need medication. Even so, it is common to reduce the amount of medication or dosage.
Treatment without surgery consists of reducing salt in the patient’s diet and controlling symptoms. This treatment is the usual one in secondary hyperaldosteronism, since surgery is not usually applied in this case.
Which specialist treats it?
Primary hyperaldosteronism is treated by a nephrologist.