Primary aldosteronism, also known as Conn's syndrome, is a hormonal disorder where the adrenal glands produce excessive amounts of aldosterone hormone. It is caused by benign tumors or hyperplasia of the adrenal glands that trigger uncontrolled aldosterone secretion, leading to sodium retention and potassium loss. The Aldosterone/Plasma Renin Activity Ratio test is the most important test for diagnosing this condition.
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Primary aldosteronism is caused by benign tumors called aldosterone-producing adenomas or bilateral adrenal hyperplasia where both adrenal glands become overactive. These growths trigger the adrenal glands to produce excessive amounts of aldosterone hormone, which normally regulates sodium and potassium balance in your body. The excess aldosterone causes your kidneys to retain too much sodium and excrete too much potassium, leading to high blood pressure that is often resistant to standard treatment and dangerously low potassium levels that can cause muscle weakness and heart rhythm problems.
The Aldosterone/Plasma Renin Activity Ratio test is the most important test for primary aldosteronism because it detects the characteristic hormonal imbalance of this condition. In primary aldosteronism, your aldosterone levels are abnormally high while your renin levels are suppressed, creating an elevated ratio that strongly suggests the diagnosis. This single blood test measures both hormones simultaneously using advanced LC/MS/MS technology for precise results. An elevated ratio typically indicates that your adrenal glands are producing excess aldosterone independently of the normal regulatory mechanisms, confirming the diagnosis and prompting further evaluation to determine whether you have an adrenal tumor or hyperplasia.
You should get tested if you have high blood pressure that requires three or more medications to control, or if your blood pressure remains elevated despite treatment. Testing is especially important if you develop unexplained low potassium levels, experience muscle weakness or cramps, have excessive urination or thirst, or have been diagnosed with hypertension at a young age (under 40). You should also consider testing if you have a family history of early-onset hypertension or stroke, as early detection of primary aldosteronism can prevent serious cardiovascular complications and help your doctor choose the most effective treatment approach.
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What this means
Your aldosterone level is elevated above the optimal range, which may be contributing to high blood pressure and electrolyte imbalances. Elevated aldosterone causes your body to retain sodium and lose potassium, which can lead to symptoms like muscle weakness, fatigue, and persistent hypertension that's difficult to control with standard medications.
Recommended actions
Reduce sodium intake to less than 2,000 mg per day to help manage blood pressure
Increase potassium-rich foods like bananas, spinach, avocados, and sweet potatoes
Monitor blood pressure regularly at home and keep a log for your doctor
Follow up with an endocrinologist to discuss potential causes and treatment options
Consider retesting in 8-12 weeks after implementing dietary changes
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