primary hyperaldosteronism

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In Conn's syndrome there are high aldosterone levels in the absence of activation of the renin-angiotensin system.

  • first described by Conn in 1955 in a patient presenting with resistant hypertension and hypokalemia who was found to have an aldosterone-secreting adrenal adenoma
    • the adenoma is characterized by increased aldosterone secretion from the adrenal glands, suppressed plasma renin, hypertension, and hypokalemia

Classical Conn's syndrome should be considered in a patient who is not on diuretics who has the following features:

  • hypertension
  • hypokalaemia
  • alkalosis

Sodium is usually mildly elevated or normal.

There is an increasing frequency in the diagnosis of primary aldosteronism (1):

  • principal reason for the increasingly frequent diagnosis of this disease, once viewed as rare, is that normokalemic Conn's syndrome is now recognized as an independent disease entity
  • normal serum potassium may be present in up to 38% of patients, especially in patients with adrenal hyperplasia or familial aldosteronism
  • found in 5% to 18% of patients with high blood pressure


  • Aronova A, Fahey TJ III, Zarnegar R. Management of hypertension in primary aldosteronism. World J Cardiol. 2014 May 26;6(5):227-33

Last edited 08/2021 and last reviewed 08/2021