Primary aldosteronism 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. This condition occurs when your adrenals, two small glands located on the top of the kidney, produce too much of aldosterone. Aldosterone is a hormone
that helps balance the levels of sodium (salt) and potassium in your body. Having too much aldosterone causes the body to hold on to sodium, resulting in salt and water build-up and a rise in blood pressure. Uncontrolled high blood pressure
can put you at risk for stroke, heart attack, heart failure, or kidney failure. The risk of heart disease
may be even greater in people with PA than in other people with high blood pressure.
Clinical features of primary aldosteronism.
High blood pressure that requires more than three medications to manage High blood pressure that started at a young age (less than age 30) Family history
at a young age Low potassium level in your blood (called hypokalemia)
To diagnose PA, your doctor will measure the levels of aldosterone and renin
in your blood. Renin
is a protein produced by the kidneys that helps regulate blood pressure. In PA, renin
levels are low and aldosterone levels are high. If PA is diagnosed, your doctor will obtain an adrenal imaging study (usually CT or MRI) to see whether you might have one tumor
or bilateral adrenal tumors (on both sides).
Treatment of PA depends on its cause and can include medication or surgery. If you and your doctor decide to pursue surgery, many times your doctor will order a test called "adrenal vein sampling", taking blood samples from each adrenal vein to measure aldosterone and cortisol. This test will demonstrate which adrenal gland(s) produces aldosterone in excess. If both adrenal glands are overactive, treatment with medication and lifestyle changes is often preferred over surgery. Your doctor may prescribe a special type of diuretic (“water pill”) that works to block the action of aldosterone in your body. You will also need to limit sodium (salt) in your diet.
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