Primary Aldosteronism

Abstract

It is now almost 15 years since Dr. Jerome Conn focused so sharply and accurately upon the occurrence of a hypertensive syndrome caused by a tumor of the adrenal cortex. The adenoma was considered to be producing in excess the normally secreted salt-retaining steroid of the adrenal gland, aldosterone, and, thus, the term primary aldosteronism was used. Furthermore, surgical removal of the tumor led to a reduction in the level of the elevated blood pressure. Clinicians everywhere quickly began the search for other patients with this disorder. Conn had established some very clear-cut criteria by which to judge preoperatively the existence of the tumor: a low serum potassium level, a low sodium to potassium concentration ratio in the saliva, a low serum chloride level, an elevated serum bicarbonate level, an elevated plasma pH, an increased excretion of aldosterone, and the excretion of normal amounts of other adrenal steroids. In subsequent