Primary Aldosteronism (Conn's Syndrome)
What is primary aldosteronism (Conn’s syndrome)?
Primary aldosteronism means the adrenal glands produce too much of the steroid hormone aldosterone, which helps regulate sodium and potassium excretion. The adrenal glands are two small triangular glands, one on top of each kidney.
This condition, also called Conn’s syndrome, results from overproduction of aldosterone by one or both adrenal glands. Overproduction of aldosterone by both glands, noncancerous masses in one adrenal gland or, very rarely, cancerous tumors, can cause overproduction of aldosterone.
Primary aldosteronism usually manifests with high blood pressure and low potassium levels in the blood. Left unchecked, high blood pressure raises your risk for complications including heart attack and stroke, while low potassium can cause heart rhythm irregularities.
Who is likely to have primary aldosteronism (Conn’s syndrome)?
Anyone can develop primary aldosteronism. But it’s more likely to be present if you have:
- Low blood potassium levels (hypokalemia).
- High blood pressure starting before age 30.
- High blood pressure requiring three or more medications to manage.
- An adrenal mass.
Symptoms and Causes
What causes primary aldosteronism (Conn’s syndrome)?
Primary aldosteronism results from overproduction of aldosterone by the adrenal glands themselves. This hormone helps regulate the body’s balance of water and sodium (salt), blood volume and blood pressure.
In some cases, primary aldosteronism results from benign, or noncancerous, tumors in one or both adrenal glands.
Rarely, primary aldosteronism occurs because of an inherited disorder. In extremely rare cases, cancerous tumors in one or both adrenal glands cause primary aldosteronism .
What are the symptoms of primary aldosteronism (Conn’s syndrome)?
Primary aldosteronism generally causes high blood pressure with low potassium.
Other symptoms may include:
- Excessive thirst.
- Frequent urination.
- Muscle cramps.
- Visual disturbances.
- Weakness or tingling.
Diagnosis and Tests
How is primary aldosteronism (Conn’s syndrome) diagnosed?
Doctors diagnose primary aldosteronism by measuring the levels of hormones like aldosterone and renin along with electrolytes, including sodium and potassium in patients with high blood pressure. Electrolytes are minerals that help balance the amount of water in your body.
Your healthcare provider may recommend further testing to rule out adrenal gland tumors. These may include:
- Computerized tomography (CT) scan, which uses X-rays to create pictures of internal body structures.
- Magnetic resonance imaging (MRI) using radio waves and high-powered magnets to visualize the inside of your body.
Management and Treatment
How is primary aldosteronism (Conn’s syndrome) treated?
If the extra aldosterone is produced by both adrenal glands it is usually treated with medications like spirinolacone (brand name Aldactone®) or eplerenone (Inspra®) which block the effects of aldosterone. If it is produced by one adrenal gland, removing that gland is an alternative to those medications.
Your doctor may also recommend lifestyle changes, including:
- Frequent exercise.
- Limiting alcohol intake.
- Reducing sodium in your diet.
- Stopping smoking.
What complications are associated with primary aldosteronism (Conn’s syndrome)?
If you don’t treat primary aldosteronism your blood pressure may increase to dangerous levels. It also disrupts the balance of electrolytes in the body.
Electrolyte imbalances and prolonged high blood pressure increase your risk for serious complications, including:
- Heart attack or heart failure.
- Irregular heartbeat.
- Kidney failure.
- Temporary paralysis, or the inability to move.
Can primary aldosteronism (Conn’s syndrome) be prevented?
There is no way to prevent primary aldosteronism. Monitoring your blood pressure frequently can help spot problems.
Outlook / Prognosis
What is the prognosis (outlook) for people with primary aldosteronism (Conn’s syndrome)?
Patients with primary aldosteronism can be managed with medications. If the aldosterone is coming from a tumor in one gland they can potentially be cured by surgery to remove adrenal gland tumors.
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