Overview

Primary aldosteronism (al-DOS-tuh-ro-niz-um) is a hormonal disorder that leads to high blood pressure. It occurs when your adrenal glands produce too much of a hormone called aldosterone.

Your adrenal glands produce a number of essential hormones, including aldosterone. Usually, aldosterone balances sodium and potassium in your blood. But too much of this hormone can cause you to lose potassium and retain sodium. That imbalance can cause your body to hold too much water, increasing your blood volume and blood pressure.

Treatment options include medications, surgery and lifestyle changes.

Symptoms

Primary aldosteronism often doesn't cause clear symptoms. The first clue that you may have primary aldosteronism is usually high blood pressure, especially hard to control blood pressure.

Sometimes, primary aldosteronism causes low potassium levels. If this happens, you may have:

  • Muscle cramps
  • Weakness
  • Fatigue
  • Headache
  • Excessive thirst
  • A frequent need to urinate

When to see a doctor

Ask your doctor about the possibility of having primary aldosteronism if you have:

  • Moderate to severe high blood pressure, especially if you need many medications to control your blood pressure
  • High blood pressure and a family history of primary aldosteronism
  • High blood pressure and a family history of high blood pressure or stroke at age 40 or younger
  • High blood pressure and a growth on one of your adrenal glands (found in an imaging test done for another reason)
  • High blood pressure and a low potassium level
  • High blood pressure and obstructive sleep apnea

Causes

Common conditions that can cause too much aldosterone include:

  • A benign growth in an adrenal gland
  • Overactivity of both adrenal glands

There are other, much rarer causes of primary aldosteronism, including:

  • A cancerous growth on the outer layer of the adrenal gland
  • An inherited condition that causes high blood pressure in children and young adults

Complications

Primary aldosteronism can lead to high blood pressure and low potassium levels. These complications in turn can lead to other problems.

Problems related to high blood pressure

Persistently elevated blood pressure can lead to problems with your heart and kidneys, including:

  • Heart attack, heart failure and other heart problems
  • Stroke
  • Kidney disease or kidney failure

People with primary aldosteronism have a higher than expected risk of cardiovascular problems compared with people who only have high blood pressure.

Problems related to low potassium levels (hypokalemia)

Primary aldosteronism may cause low potassium levels. If your potassium levels are just slightly low, you may not have any symptoms. Very low levels of potassium can lead to:

  • Weakness
  • Irregular heart rhythm
  • Muscle cramps
  • Excess thirst or urination