Primary Hyperaldosteronism (Conn's Syndrome)
What is Primary Hyperaldosteronism (Conn's Syndrome)?
Primary hyperaldosteronism is a hormonal condition where your adrenal glands make too much aldosterone. This hormone controls how your kidneys handle sodium and potassium. When aldosterone levels are too high, your body holds onto sodium and loses potassium through urine.
The condition causes high blood pressure that can be hard to control with typical medications. It also leads to low potassium levels in your blood, a condition called hypokalemia. Many people with primary hyperaldosteronism don't know they have it because symptoms can be subtle at first.
Doctors estimate that 5 to 10 percent of people with high blood pressure have this condition. That makes it one of the most common causes of secondary hypertension, or high blood pressure with a specific underlying cause. Finding and treating it early helps prevent heart disease, stroke, and kidney damage.
Symptoms
- High blood pressure that is difficult to control with medication
- Muscle weakness or cramps from low potassium
- Frequent urination, especially at night
- Extreme thirst
- Fatigue and tiredness throughout the day
- Headaches
- Numbness or tingling in the arms or legs
- Irregular heartbeat or palpitations
Many people with primary hyperaldosteronism have no obvious symptoms early on. High blood pressure may be the only sign. Some people have normal potassium levels despite the condition, which can make diagnosis more challenging.
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Causes and risk factors
Primary hyperaldosteronism happens when one or both adrenal glands produce too much aldosterone hormone. The most common cause is a benign tumor on one adrenal gland, called an aldosterone-producing adenoma. This accounts for about 35 percent of cases. Another common cause is bilateral adrenal hyperplasia, where both adrenal glands are overactive. This affects about 60 percent of people with the condition.
Risk factors include having resistant high blood pressure, meaning your blood pressure stays high despite taking three or more medications. Having low potassium levels alongside high blood pressure is another major red flag. Family history plays a role in rare inherited forms. The condition can develop at any age but is most often diagnosed in people between 30 and 50 years old.
How it's diagnosed
Diagnosis starts with blood tests to check your potassium and sodium levels. Low potassium with high or high-normal sodium in someone with high blood pressure suggests this condition. These basic screening tests can reveal the characteristic electrolyte pattern of excessive aldosterone.
Rite Aid offers testing for potassium and sodium levels as part of our flagship blood panel. If your results show abnormal levels, your doctor may order specialized hormone tests to measure aldosterone and renin directly. Additional imaging tests like CT scans help identify tumors or enlarged adrenal glands once blood work confirms the diagnosis.
Treatment options
- Medications called mineralocorticoid receptor antagonists, like spironolactone or eplerenone, block aldosterone's effects
- Surgery to remove an aldosterone-producing tumor if one adrenal gland is affected
- Blood pressure medications to control hypertension
- Potassium supplements if levels are low, though medication often corrects this
- Reduce sodium intake to less than 2,300 milligrams per day
- Eat potassium-rich foods like bananas, sweet potatoes, spinach, and avocados
- Maintain a healthy weight through balanced nutrition
- Exercise regularly, aiming for 150 minutes of moderate activity per week
- Limit alcohol consumption
- Monitor blood pressure at home and track your readings
Concerned about Primary Hyperaldosteronism (Conn's Syndrome)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Primary hyperaldosteronism means the problem starts in the adrenal glands themselves, which make too much aldosterone. Secondary hyperaldosteronism happens when something else, like kidney disease or heart failure, causes high aldosterone levels. Primary hyperaldosteronism is a condition of the adrenal glands, while secondary is a response to another medical problem.
Yes, it can sometimes be cured with surgery if a single tumor is causing the problem. Removing the affected adrenal gland often resolves high blood pressure and corrects potassium levels. When both glands are overactive, medication can effectively manage the condition long term. About 30 to 60 percent of people who have surgery see their blood pressure return to normal.
Aldosterone tells your kidneys to hold onto sodium and release potassium into urine. When aldosterone levels are too high, your kidneys excrete excessive amounts of potassium. This leads to hypokalemia, or low blood potassium levels. The potassium loss can affect muscle function, heart rhythm, and overall energy levels.
If you have high blood pressure or known primary hyperaldosteronism, check your levels every 3 to 6 months. More frequent testing may be needed when starting new medications or adjusting doses. Regular monitoring helps ensure your treatment is working and prevents dangerous electrolyte imbalances. Your doctor will recommend a testing schedule based on your individual situation.
You should get tested if your blood pressure stays above 140/90 despite taking medication. Resistant hypertension, meaning high blood pressure on three or more drugs, is a strong indicator. Young people with high blood pressure, especially under age 30, should also be screened. Anyone with high blood pressure and low potassium needs evaluation for this condition.
Diet changes support treatment but cannot cure the condition. Reducing sodium intake helps lower blood pressure and reduces fluid retention. Eating potassium-rich foods supports healthy levels, though medication is usually needed too. A diet rich in vegetables, fruits, whole grains, and lean proteins supports overall cardiovascular health while managing symptoms.
Untreated primary hyperaldosteronism significantly increases your risk of heart disease and stroke. The persistent high blood pressure damages blood vessels and strains your heart. Low potassium can cause dangerous heart rhythm problems. Over time, kidney damage and heart failure become more likely. Early detection and treatment prevent these serious consequences.
Most cases are not inherited and occur randomly. Rare genetic forms called familial hyperaldosteronism do run in families. These account for less than 5 percent of all cases. If you have a family member with early onset high blood pressure or known primary hyperaldosteronism, mention this to your doctor.
Medication typically lowers blood pressure within 4 to 6 weeks of starting treatment. Potassium levels often normalize within days to weeks. After surgery to remove a tumor, blood pressure may improve within weeks but can take up to a year to stabilize. Regular follow-up testing helps track your response and adjust treatment as needed.
No, stress and lifestyle do not cause primary hyperaldosteronism. The condition results from physical changes in the adrenal glands, like tumors or overgrowth. Lifestyle factors like diet and stress can affect blood pressure in general, but they do not trigger excess aldosterone production. The root cause is hormonal and anatomical, requiring medical treatment.