Hyperaldosteronism: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hyperaldosteronism?
An endocrinologist, a hormone doctor, usually treats this condition. Your doctor may refer you to one after a positive screening test. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hyperaldosteronism?
Hyperaldosteronism is a condition in which the adrenal gland releases too much of the hormone aldosterone into the blood. The adrenal glands are small glands on top of each kidney. Aldosterone helps control blood pressure and balance sodium and potassium in your body.
It can be primary or secondary. Primary aldosteronism is the most common hormonal cause of high blood pressure. It affects 5-14% of all people with high blood pressure. Most people who have it do not know they have it.
Symptoms
Both types have common symptoms, including:
- High blood pressure.
- A low level of potassium in the blood.
- Feeling tired all the time.
- Headache.
- Muscle weakness.
- Numbness.
Many people with primary aldosteronism have no symptoms except high blood pressure. The usual medicines for high blood pressure may not work for them.
Low potassium can make a person feel weak and tired. In serious cases, it can make muscles stiffen and become hard to move. It can also make the heart beat too fast or irregularly. Not everyone with it has low potassium.
Causes and who gets it
The primary type is due to a problem of the adrenal glands themselves. Most cases are caused by a noncancerous tumor of the adrenal gland.
Secondary hyperaldosteronism is due to a problem elsewhere in the body. It makes the adrenal glands release too much aldosterone. These problems can involve genes, diet, or medical disorders of the heart, liver, or kidneys.
The condition mostly affects people 30 to 50 years old. It is a common cause of high blood pressure in middle age.
You might be more likely to have primary aldosteronism if you have:
- High blood pressure that is hard to control with standard medicines.
- Low potassium levels in your blood.
- Family members with it.
- High blood pressure at a young age (under 40).
- High blood pressure along with sleep apnea or diabetes.
How doctors diagnose it
Your provider will do a physical exam and ask about your symptoms. Tests that may be ordered include:
- An abdominal CT scan.
- A blood aldosterone level.
- Blood renin activity.
- A blood potassium level.
- A urine aldosterone test.
- A kidney ultrasound.
Renin is a protein that works with aldosterone to regulate blood pressure. The first screening step is a blood test for aldosterone and renin.
A positive screening test does not necessarily mean you have the condition. Next steps may include more tests to confirm the diagnosis and imaging of your adrenal glands.
Another test puts a catheter, a thin tube, into the veins of the adrenal glands. It checks which of the two adrenal glands is making too much aldosterone. You may need to stop taking some medicines before testing, so follow your provider's instructions.
Treatment
Surgery often treats the primary type when a tumor of the adrenal gland causes it. It can sometimes be treated with medicines. Removing the tumor may control the symptoms. Even after surgery, some people still have high blood pressure and need medicine for it.
Limiting salt and taking medicine may control the symptoms without surgery. Medicines used include:
- Medicines that block the action of aldosterone.
- Water pills (diuretics), which help manage fluid buildup in the body.
Long-term use of medicines that block aldosterone may cause erection problems and enlarged breast tissue in men.
The secondary type is treated with medicines and limiting salt. Surgery is usually not used.
When to see a doctor
Contact your provider if you develop symptoms of this condition. Primary hyperaldosteronism can cause very high blood pressure. That can damage many organs, including the eyes, kidneys, heart, and brain.
Call 911 or go to the emergency room if you have chest pain, fainting, severe trouble breathing, sudden weakness, trouble speaking, or sudden vision changes.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check your blood pressure and order first blood tests. They can also help coordinate visits with a hormone specialist.
Common questions
What is the difference between primary and secondary hyperaldosteronism?
Primary hyperaldosteronism is due to a problem of the adrenal glands themselves. Secondary is due to a problem elsewhere in the body.
Can hyperaldosteronism be cured?
Sometimes, in primary aldosteronism caused by a small tumor in one adrenal gland. In that case, surgery to remove that adrenal gland may cure the condition. Even after surgery, some people still need medicine for high blood pressure.
Does hyperaldosteronism cause high blood pressure?
Yes, high blood pressure is a common symptom of both types. Primary aldosteronism is the most common hormonal cause of high blood pressure.
Who should be screened for primary aldosteronism?
The Endocrine Society recommends screening all patients with high blood pressure. Screening starts with a blood test for aldosterone and renin.
Sources
- MedlinePlus - Primary and secondary hyperaldosteronism
- Endocrine Society - Understanding Primary Aldosteronism: A Guide for Patients with High Blood Pressure
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
