Overview
Definition
An endocrine disorder characterized by the autonomous, excessive production of aldosterone from the adrenal cortex, leading to hypertension and hypokalemia.
Epidemiology
Underdiagnosed cause of hypertension; accounts for 5-10% of all hypertensive patients.
Etiology & Risk Factors
- Adrenal adenoma (Conn's Syndrome, 30-40%)
- Bilateral adrenal hyperplasia (60%)
- Adrenal carcinoma (rare)
Clinical Symptoms
- Treatment-resistant hypertension
- Muscle weakness and cramps (due to hypokalemia)
- Polydipsia and polyuria
Clinical Approach
Diagnosis
- Screening: Elevated Aldosterone-to-Renin Ratio (ARR > 20-30)
- Confirmation: Oral salt loading or saline infusion test showing failure to suppress aldosterone
- CT Adrenals and adrenal venous sampling (AVS) to localize
Management
- Unilateral adenoma: Surgical adrenalectomy
- Bilateral hyperplasia: Aldosterone antagonists (Spironolactone, Eplerenone)
Complications
- Left ventricular hypertrophy
- Stroke / Cardiovascular disease
- Chronic Kidney Disease
- Atrial Fibrillation