Primary aldosteronism

Primary Aldosteronism (PA)

Primary Aldosteronism (PA), also known as primary hyperaldosteronism or Conn's syndrome, is a condition characterized by the excessive production of aldosterone, a hormone produced by the adrenal glands. Aldosterone helps regulate blood pressure by controlling the balance of sodium and potassium in the blood. When too much aldosterone is produced, it leads to low levels of renin (a hormone that regulates blood pressure and water balance), high blood pressure (hypertension), potassium deficiency, and a range of other symptoms.

Causes

PA can be caused by one or more factors, including:

• Adrenal Hyperplasia: The enlargement of both adrenal glands.
• Adrenal Adenoma: A benign tumor in one of the adrenal glands.

In rare cases, PA can result from familial genetic conditions.

Diagram showing the location of the adrenal glands.

Symptoms

Symptoms of primary aldosteronism may vary and include:

• High blood pressure that is difficult to control with medication.
• Fatigue and muscle weakness.
• Muscle spasms and cramps.
• Low back and flank pain.
• Trembling and tingling sensations.
• Dizziness or vertigo.
• Nocturia (excessive urination at night) and frequent urination.
• Poor vision, confusion, or headaches due to high blood pressure.

Diagnosis

Diagnosis of PA involves a series of tests, including:

• Blood tests to measure aldosterone and renin levels.
• Imaging tests (CT scan or MRI) to identify any abnormalities in the adrenal glands.
• Adrenal vein sampling to determine which gland is overproducing aldosterone.

Treatment

Treatment for PA depends on the underlying cause and may include:

• Medication: Drugs that block the action of aldosterone can be effective in controlling blood pressure and correcting potassium levels.
• Surgery: In cases where a tumor is present, surgical removal of the affected adrenal gland may be recommended.
• Lifestyle Changes: Dietary adjustments, particularly reducing salt intake, can help manage symptoms.

Complications

If left untreated, PA can lead to serious health issues, including:

• Cardiovascular disease (stroke, myocardial infarction).
• Kidney failure.
• Abnormal heart rhythms (arrhythmias).

External Links

• National Institute of Diabetes and Digestive and Kidney Diseases - Primary Aldosteronism
• Mayo Clinic - Primary Aldosteronism

References

• The Diagnosis and Treatment of Primary Aldosteronism in the Hypertensive Patient by the American College of Cardiology.
• Primary Aldosteronism: Practical Approach to Diagnosis and Management by the Circulation Journal.

Primary aldosteronism Resources
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