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Pathophysiology and clinical features of primary aldosteronism

William F Young, Jr, MD, MSc
Section Editor
André Lacroix, MD
Deputy Editor
Kathryn A Martin, MD


Nonsuppressible (primary) hypersecretion of aldosterone is an underdiagnosed cause of hypertension. The classic presenting signs of primary aldosteronism are hypertension and hypokalemia, but potassium levels are often normal in modern-day series of aldosteronomas.

The pathophysiology and clinical features of primary aldosteronism will be reviewed here. The treatment of this disorder and an approach to the diagnosis of hypertension and hypokalemia are discussed separately. (See "Treatment of primary aldosteronism" and "Diagnosis of primary aldosteronism".)


Renin-independent, incompletely suppressible (primary) hypersecretion of aldosterone is an increasingly recognized but still underdiagnosed cause of hypertension [1]; it is estimated to be responsible for 5 to 13 percent of hypertension in humans. Many subtypes of primary aldosteronism have been described since Conn's original report of the aldosterone-producing adenoma (APA) in 1954 [2-5].

The most frequent causes of primary aldosteronism include:

Bilateral idiopathic hyperaldosteronism (or idiopathic hyperplasia [IHA], 60 to 70 percent)


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Literature review current through: Nov 2016. | This topic last updated: Wed Oct 19 00:00:00 GMT+00:00 2016.
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