How is it diagnosed?
The doctor suspected primary hyperaldosteronism in a patient with hypertension, typically severe or refractory, which is evidence of the existence of low blood potassium in urine losses of the same, if not taking diuretics.
In such cases, an analysis of blood levels of renin and aldosterone. If the first is below the normal range and the second one has high diagnosis.
These tests may be altered by certain drugs, which requires removing those drugs that affect the “renin-angiotensin system.” (Converting enzyme inhibitors, antagonists of the angiotensin II receptor blockers, beta blockers and diuretics among others).
At other times are needed to determine special conditions such as: intravenous saline overload, the determination of aldosterone in the urine of 24 after three days of an oral saline and saline overload test with oral fludrocortisone.
Once confirmed the high rates of aldosterone imaging tests are performed to find the “adenoma” or “hyperplasia”: computed tomography or magnetic resonanacia abdomen and / or adrenal scintigraphy.
Treatment
When the source is an adenoma is surgical treatment. The abnormal gland removal corrects the hypertension and potassium deficiency in most patients. It can happen, despite the surgery, blood pressure levels remain high for having a well established essential hypertension. However, many drugs are needed to control as before the intervention.
If there is a single tumor, as is the case with the hyperplasia of both adrenal glands, or a high risk for surgery, specific treatment is with spironolactone (antagonist of aldosterone receptors) whose opposite effect of the hormone, provides a good clinical long-term blood pressure control.
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