Aldosteronism is a medical condition characterized by an abnormally elevated level of the adrenal gland hormone aldosterone. The hormone stimulates kidney retention of sodium and water, commonly leading to high blood pressure, or hypertension. Several diseases and conditions can cause different types of aldosteronism. Treatment for aldosteronism depends on the underlying cause of the disorder.
Categories
Primary aldosteronism refers to adrenal gland abnormalities that lead to an elevated aldosterone level. Complex control systems normally regulate the aldosterone level. With primary aldosteronism, however, the adrenal glands produce the hormone in an unregulated fashion.
Secondary aldosteronism occurs when conditions outside the adrenal glands provoke excess aldosterone production. With secondary aldosteronism, the adrenal glands respond normally to increased stimulation, triggering the production and release of large quantities of aldosterone.
Primary Aldosteronism
The causes of primary aldosteronism include noncancerous adrenal tumors, cancerous adrenal tumors and overgrowth of the aldosterone-producing adrenal tissue. Adrenal adenomas are noncancerous, or benign, tumors of the outer adrenal gland, which often produce aldosterone in an unregulated manner. These tumors affect women more frequently than men, report Dr. Florencia Halperin of Brigham and Women's Hospital and colleagues on the endocrinology reference website Endotext. Surgical removal of the affected adrenal gland proves the treatment of choice for these tumors.
Adrenocortical carcinomas are cancerous tumors arising from the outer tissue of the adrenal gland, the adrenal cortex. Adrenocortical carcinoma proves rare, occurring at a rate of approximately one to two cases per million persons, reports the National Cancer Institute. Surgical removal of the cancerous adrenal gland provides the best chance for cure.
Overgrowth of the adrenal cortex, or adrenal hyperplasia, represents a noncancerous process in which the involved tissue spontaneously grows without forming a distinct tumor. Treatment for adrenal hyperplasia usually involves medications to block the effects of excess aldosterone and lower blood pressure, notes "The Merck Manual for Healthcare Professionals."
Secondary Aldosteronism
Conditions that decrease the volume of blood flow received by the kidneys frequently cause secondary aldosteronism. Possible causes of secondary aldosteronism include narrowing of the arteries that supply blood to the kidneys, advanced cirrhosis of the liver, heart failure and certain types of kidney disease, reports "The Merck Manual for Healthcare Professionals."
Features
Primary and secondary aldosteronism typically cause treatment-resistant high blood pressure--that is, hypertension that fails to decrease with high blood pressure medicines. Laboratory testing commonly reveals an abnormally low blood potassium level because the kidneys excrete large quantities of potassium under the influence of aldosterone. Possible physical symptoms associated with primary and secondary aldosteronism include muscle weakness, headaches and numbness, reports the National Library of Medicine encyclopedia MedlinePlus.
Significance
The American Heart Association reports that, as of 2006, more than one-third of the adult population in the United States has hypertension. The Endocrine Society estimates that more than 10 percent of patients with high blood pressure have underlying primary aldosteronism. Detection and definitive treatment of primary aldosteronism may cure hypertension in many of these patients.
References
- The Merck Manual for Healthcare Professionals: Primary Aldosteronism (Conn's Syndrome)
- Endotext: Aldosterone Excess
- National Cancer Institute: Adrenocortical Carcinoma Treatment, General Information
- The Merck Manual for Healthcare Professionals: Secondary Aldosteronism
- MedlinePlus: Hyperaldosteronism - Primary and Secondary
