Primary hyperaldosteronism

• Hypertension in the presence of elevated aldosterone and suppressed plasma renin
• Two major causes are aldosteronoma and idiopathic hyperaldosteronism (IHA)

Aldosteronoma

• 60% of cases
• more often in women
• Hypertension and hypokalemia is more severe compared with IHA
• Salt loading does not change aldosterone levels
• CT usually reveals a small solitary adrenal tumor
• Adrenal vein sampling will reveal unilateral hypersecretion of aldosterone.
• Treatment is surgical resection

Idiopathic Hyperaldosteronism (IHA)

• 30% of cases
• More often in Men
• Salt loading decreases aldosterone levels
• CT reveals normal to bilaterally enlarged glads
• Adrenal vein sampling reveals bilateral hypersecretion of aldosterone
• Treatment is with potassium sparing diuretics – spironolactone