MAY 26, 2020

High Blood Pressure: The Prevalence of Aldosteronism

WRITTEN BY: Lawrence Renna

In a recent study published in the Annals of Internal Medicine, researchers are advising healthcare professionals to screen for primary aldosteronism more often and consider it as a possible primary cause of high blood pressure. The authors of the study found that the condition was more common than expected.

According to the Mayo Clinic: “Primary aldosteronism is a hormonal disorder that leads to high blood pressure.” Further, “it occurs when your adrenal glands produce too much of a hormone called 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.” The most common causes of aldosterone include a benign growth in an adrenal gland and overactivity in the adrenal glands.

Primary aldosteronism is generally thought of as a secondary cause of high blood pressure. However, Jenifer M. Brown, MD at Brigham & Women’s Hospital says of the latest study that there is a “need to redefine primary aldosteronism from a rare and categorical disease to, instead, a common syndrome that manifests across a broad severity spectrum and may be a primary contributor to hypertension pathogenesis.”

The participants of the study were administered an oral sodium suppression test for primary aldosteronism and to quantify the magnitude of aldosterone production. Also, aldosterone was measured in the urine of participants with high sodium and suppressed renin activity. High levels of aldosterone were highly correlated with high blood pressure.

The study concluded that “the prevalence of primary aldosteronism is high and largely unrecognized. Beyond this categorical definition of primary aldosteronism, there is a prevalent continuum of renin-independent aldosterone production that parallels the severity of hypertension. These findings redefine the primary aldosteronism syndrome and implicate it in the pathogenesis of “essential” hypertension.”

Sources: Healio.com, Mayo ClinicAnnals of Internal Medicine