Primary aldosteronism

Primary aldosteronism is excess aldosterone production by the adrenal glands that is partly or wholly independent of renin. It causes sodium retention, potassium loss, and often high blood pressure.

Aldosterone: A steroid hormone made mainly by the adrenal cortex that regulates sodium and potassium balance. Its excessive, renin-independent secretion defines this disorder.
Aldosterone-to-renin ratio: A screening measure comparing blood aldosterone concentration with renin activity or concentration. A high ratio can flag aldosterone excess with suppressed renin for confirmatory evaluation.
Bilateral adrenal hyperplasia: Enlargement or increased cell growth in both adrenal glands, which can increase hormone secretion. This is a common cause of primary aldosteronism and usually calls for medication rather than unilateral surgery.
Secondary hyperaldosteronism: Increased aldosterone secretion driven by an upstream stimulus, usually elevated renin. Unlike primary aldosteronism, this condition typically has renin-driven aldosterone elevation.
Resistant hypertension: Blood pressure that remains above target despite use of multiple appropriately chosen antihypertensive medications. Primary aldosteronism is a treatable cause to consider when hypertension resists standard therapy.
Renin–angiotensin–aldosterone system: A hormonal system that regulates blood pressure and fluid balance through renin, angiotensin, and aldosterone. Primary aldosteronism disrupts its usual renin control of aldosterone.
Saline infusion test: A suppression test that measures whether intravenous saline lowers aldosterone secretion as expected. Failure to suppress aldosterone supports autonomous secretion after an abnormal screening result.
Aldosterone-producing adenoma: A usually benign adrenal cortical tumor that secretes aldosterone. A unilateral source can make adrenalectomy an option when testing confirms lateralized secretion.
Renovascular hypertension: High blood pressure caused by reduced blood flow to one or both kidneys, often from renal artery narrowing. Reduced kidney perfusion can raise renin and aldosterone, unlike the suppressed renin typical of primary disease.
Atrial fibrillation: A common abnormal heart rhythm marked by disorganized electrical activity in the atria. Aldosterone excess is associated with increased atrial fibrillation risk beyond blood-pressure effects alone.

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