Hyperaldosteronism is a condition manifested by excessive aldosterone secretion from the adrenal glands resulting in sodium (Na) retention and potassium (K) loss.

The two types of the condition are:

• Primary which is due to an adenoma in the cortex of the adrenal gland usually seen in only one of the two adrenals. Rarely, cancer or hyperplasia is the cause.

• Secondary which results from stimuli originating outside the adrenal gland that causes an increased production of aldosterone. Causes of this type include: renal artery stenosis, hypovolemia, and congestive heart failure (CHF).

The oversecretion of aldosterone results in excess sodium in the blood, hypervolemia, and hypokalemia. Diastolic hypertension may occur without edema, and headaches may ensue. In addition, polyuria, polydipsia, and nocturia may also occur. These changes are manifested in weakness, numbness, transient paralysis, and possible tetany. However, a great number of cases manifest only in modest hypertension.

Sodium and potassium levels are determined to indicate hypernatremia and hyperkalemia. An improvement in hypertension symptoms after 5 to 8 weeks on a diuretic indicates that the high blood pressure is due to increased aldosterone levels. Measuring plasma renin and aldosterone levels may be helpful to distinguish primary and secondary forms of the condition. Venous sampling of both adrenals is used in the localization of adenomas. Computed tomography (CT) scan may show a small adenoma.

For patients with primary hyperaldosteronism due to adrenocortical adenoma, the treatment of choice is adrenalectomy. If the cause is hyperplasia, then about 70% of patients remain hypertensive. In addition to controlling the hyperaldosteronism with diuretics, administration of antihypertensive drugs is required in 50% of patients.

When a solitary adenoma is found, the prognosis is good. After adenoma removal, 50 to 70% of patients have complete remission. Adrenal hyperplasia and non-tumor hyperaldosteronism will require maintenance medication to control symptoms.

• Consider service connection on a presumptive basis as a chronic condition (38 CFR §3.307; §3.309 (a)). 

• Consider service connection on a presumptive basis as a condition associated with ionizing radiation exposure (38 CFR §3.307; §3.309 (d); §3.311 (b)).

• Evaluate as malignant or benign neoplasm, as appropriate.