About Conn’s disease
Conn’s disease, also known as Primary Aldosteronism (PA), is an illness of the adrenal glands. It occurs when one or both glands produce too much of the hormone aldosterone, which causes patients to retain sodium, and in that process, lose potassium in the urine. The excess sodium holds onto water, which can cause dangerously high blood pressure. PA can result from a tumor (that is almost always noncancerous) on one or both adrenal glands or when both glands are enlarged and overactive. Medical students are taught that they’ll probably never see this disease, yet at least 10 percent of patients with hard-to-treat hypertension may have Conn’s.
To test for Conn’s, doctors begin by measuring the levels of aldosterone and rennin, which is an enzyme produced by the kidneys that helps regulate blood pressure. Conn’s is suspected if the test shows you have low rennin and high aldosterone. You may be asked to follow a high-sodium diet for three days so your doctor can measure the aldosterone and sodium in your urine. A CT scan can help identify a bump (which might be a tumor) or other irregularity on one or both of your adrenal glands. Adrenal vein sampling, in which a radiologists draws blood from the right and left adrenal veins and compares the two samples, can detect whether one or both of the glands is affected. Treatment can involve removing the gland, or taking medications to block aldosterone, and lowering the dietary intake of sodium, while raising intake of potassium.
If your symptoms suggest Conn’s disease, you need an endocrinologist who has experience with treating the disease. If you’re between 30 and 50 and have been diagnosed with hypertension for no apparent reason, the American Medical Association says to suspect Conn’s. Having low potassium levels in addition to the high blood pressure is another red flag. And women are more likely than men to develop the condition.