Hyperaldosteronism
Hyperaldosteronism occurs when the adrenal glands produce too much aldosterone, a hormone that controls sodium and potassium balance. The excess aldosterone causes the body to retain sodium and excrete potassium, which drives blood pressure up persistently and is often resistant to standard antihypertensive treatment.
Medicine used to treat Hyperaldosteronism
Why blood pressure stays high despite treatment
Many people in Asia live with high blood pressure for years without a clear explanation. Hyperaldosteronism is believed to account for roughly 5 to 10 percent of all hypertension cases, yet it remains under-diagnosed across Southeast Asia, South Asia, and East Asia partly because it requires specific hormone testing to confirm. The tell-tale pattern is blood pressure that does not respond well to two or three standard medicines, sometimes accompanied by low potassium levels causing muscle cramps, weakness, or unusual thirst.
Primary hyperaldosteronism usually traces back to a benign tumour on one adrenal gland (Conn’s syndrome) or to both glands overproducing the hormone. Secondary hyperaldosteronism has an external trigger such as chronic kidney disease or severe heart failure.
Managing the condition
For people with bilateral adrenal overactivity, the main medical approach involves an aldosterone-blocking agent. Spironolactone is the most established option; it counters the hormone directly, helping both blood pressure and potassium levels normalise over weeks. Broader heart and blood pressure medicines are often used alongside it depending on the underlying cause.
If imaging and further tests identify a single overactive gland, surgery to remove it can resolve the condition entirely.
Unexplained high blood pressure, persistent low potassium, or both together are worth investigating with a doctor promptly, as untreated hyperaldosteronism raises the long-term risk of heart and kidney damage beyond what blood pressure alone would predict.