What is hyperaldosteronism?

Updated: Sep 08, 2020
  • Author: George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London); Chief Editor: Robert P Hoffman, MD  more...
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Hyperaldosteronism is characterized by excessive secretion of aldosterone, which causes increases in sodium reabsorption and loss of potassium and hydrogen ions. It may be either primary (autonomous) or secondary. [1, 2] Hyperaldosteronism represents part of a larger entity of hypermineralocorticoidism that may be caused by aldosterone, its mineralocorticoid precursors, or defects that modulate aldosterone effects on its target tissues. [1]  Surgical excision of the affected adrenal gland is recommended for all patients with hyperaldosteronism who have a proven aldosterone-producing adenoma (APA).

Aldosterone is a steroid hormone produced exclusively in the zona glomerulosa of the adrenal cortex. It is the major circulating mineralocorticoid in humans. Numerous aldosterone precursors, including deoxycorticosterone and 18-hydroxycorticosterone, have mineralocorticoid activity and may produce or exacerbate features typical of mineralocorticoid hypertension when present in excessive amounts in various pathologic states.

The principal site of action of aldosterone is the distal nephron, though several other sites of aldosterone-sensitive sodium regulation are noted, including the sweat glands and the gastrointestinal (GI) tract. The principal regulators of aldosterone synthesis and secretion are the renin-angiotensin system and the potassium ion concentration. Minor regulators include adrenocorticotropic hormone (ACTH) from the pituitary, atrial natriuretic peptide from the heart, and local adrenal secretion of dopamine.

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