Nonsuppressible (primary) hypersecretion of aldosterone is an uncommon but underdiagnosed cause of hypertension. The classic presenting signs of primary aldosteronism are hypertension and hypokalemia.
Many subtypes of primary aldosteronism have been described since Conn's original report of the aldosterone-producing adenoma in 1954 [1-3]. The most common subtypes are:
- Aldosterone-producing adenomas
- Bilateral idiopathic hyperaldosteronism
Less common forms include:
- Unilateral hyperplasia or primary adrenal hyperplasia (caused by micronodular or macronodular hyperplasia of the zona glomerulosa of predominantly one adrenal gland)
- Familial hyperaldosteronism type I (glucocorticoid-remediable aldosteronism), type II (the familial occurrence of aldosterone-producing adenoma or bilateral idiopathic hyperplasia or both), and type III due to KCNJ5 potassium channel mutations
- Pure aldosterone-producing adrenocortical carcinomas and ectopic aldosterone-secreting tumors (eg, neoplasms in the ovary or kidney)