Introduction:
The adrenal glands are part of the body that functions to produce a hormone (protein) known as aldosterone. The role of this hormone is to maintain blood pressure. The mechanism of maintenance of blood pressure is by regulating the levels of sodium, potassium, and water in the blood.
Aldosteronism or hyperaldosteronism is a disorder involving the endocrine system which affects one or both of the adrenal glands and thus leads to the formation of high levels of the hormone known as aldosterone. This makes the body lose high levels of potassium and retain increased levels of sodium. Thus, water retention, blood volume, and blood pressure are increased in the body.
What Are The Signs and Symptoms?
Increased blood pressure is the main symptom of hyperaldosteronism. It can range from moderate to severe. Some cases have been reported in which high blood pressure related to hyperaldosteronism has not responded to medication. However, in other patients, it may respond to a few medications or their combinations alone. High blood pressure usually does not have any symptoms. But the following may be noticed when the patient develops any symptoms:
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Dizziness.
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Headaches.
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Chest pain.
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Problems with vision.
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Shortness of breath.
Hypokalemia is another main symptom of hyperaldosteronism. Hypokalemia is a clinical condition characterized by low levels of potassium in the blood. Although it is not known to cause any symptoms, moderate cases may experience the following:
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Fatigue or tiredness.
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Increased thirst.
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Muscle cramps.
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Muscle weakness.
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Increase in urination.
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Palpitations or increased heartbeat.
How Is It Caused?
Hyperaldosteronism is classified as primary and secondary. They have similar symptoms, but they are differentiated based on their cause.
What Is Primary Hyperaldosteronism?
Primary hyperaldosteronism is caused when one or both adrenal glands are affected. It is also called Conn’s syndrome. Sometimes, it is congenital, as some people are born with overactive adrenal glands.
However, others may develop it due to the following:
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Adrenocortical cancer (it is a rare cancerous tumor that produces aldosterone).
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A benign tumor is present in one of the adrenal glands.
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Any inherited condition affecting the adrenal glands.
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Glucocorticoid-remediable aldosteronism (it is a hereditary type of aldosteronism that runs in families).
What Is Secondary Hyperaldosteronism?
Secondary hyperaldosteronism is caused due to factors other than the adrenal glands. It is usually related to a reduction in blood flow to the kidneys.
Following are the reasons that can cause it:
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Diuretic medications.
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A block or narrowing in the renal artery.
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Chronic liver disease.
How Can It Be Diagnosed?
When you visit your physician, you will be asked about your family history, personal history, and symptoms. Then, a blood test will be conducted to check the levels of aldosterone and renin. Renin is an enzyme released by the kidney and functions together with aldosterone to help maintain blood pressure. It has been observed that patients with hyperaldosteronism usually have decreased levels of renin and increased levels of aldosterone.
After you get the results of your blood test, the following tests may be done to diagnose the condition:
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Captopril challenge test.
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Salt-loading test.
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Saline infusion test.
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Fludrocortisone suppression test.
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Abdomen examination with the help of CT (computed tomography) and MRI (magnetic resonance imaging).
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Adrenal vein sample.
How Can It Be Treated?
The main idea behind treating hyperaldosteronism is focused on decreasing the aldosterone levels or blocking the effects caused due to altered levels of aldosterone, high blood pressure, and decreased blood potassium. The treatment is dependent on the cause. Following are the methods to manage it:
Medication:
The physician may prescribe you a mineralocorticoid receptor antagonist, like Spironolactone. This helps in blocking the effects of aldosterone on the body, like increased blood pressure and low potassium levels in the blood. The patient may require additional medication to maintain blood pressure levels.
Surgery:
If the tumor is the cause, then your physician will advise adrenalectomy. It is the procedure in which the affected adrenal gland is removed along with the tumor. The person may experience a decrease in blood pressure following this procedure. With follow-ups, your physician will change the medication depending on the blood pressure levels.
Changes in Lifestyle:
Lifestyle changes can enhance recovery along with medications or surgery.
Following are the lifestyle modifications that you can incorporate:
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Consume a healthy balanced diet: A balanced diet helps in maintaining a healthy weight, and thus, blood pressure can be regulated. Minimize salt intake.
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Exercise: Regularly exercising, even for just 30 minutes, like walking a few times a week, can help reduce blood pressure.
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Reduce alcohol and caffeine: Alcohol and caffeine are known to increase blood pressure. Also, some medications can show fewer effects in the presence of alcohol.
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Quit smoking: Smoking cigarettes can lead to constriction of the blood vessels. This, in turn, leads to an increase in heart rate and can also cause an increase in blood pressure. Also, smoking is known to increase the risk of experiencing a heart attack and stroke, even without increased blood pressure.
Can Aldosteronism Cause Any Complications?
Increased levels of aldosterone can lead to a variety of health issues. For example, literature shows that this condition can lead to direct injury to the tissues of the heart and ultimately cause scars and enlargement of the left side of the heart. In addition to blood vessels injury and various other complications related to an increase in blood pressure, untreated hyperaldosteronism can also prove to be a risk factor for the following:
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Heart attacks.
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Kidney failure.
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Heart failure.
It is important to have a regular follow-up with your physician to avoid any unwanted complications.
Conclusion:
Aldosteronism is an endocrine disorder related to the hormone aldosterone. It can be either primary or secondary, depending on the cause. Early diagnosis and management improve the prognosis. You can consult a specialist online through online medical platforms to know more about this condition.
