Primary aldosteronism is a group of disorders, originally described by JW Conn, in which there is a non-suppressible secretion of aldosterone and hypertension. Aldosterone is a salt-retaining hormone synthesized by the adrenal gland that is regulated by multiple factors, with the renin-angiotensin system and serum potassium being the major factors. Additional minor regulators include adrenocorticotropic hormone (ACTH), atrial natriuretic factor, and dopamine
Primary hyperaldosteronism can be caused by either hyperactivity in one adrenal gland (unilateral disease) or both (bilateral disease). Unilateral disease is usually caused by an aldosterone producing adenoma (benign tumor) and less commonly by adrenal cancer or hyperplasia (when the whole gland is hyperactive). Bilateral disease is usually caused by bilateral hyperplasia (when both glands are hyperactive). There are rare genetic syndromes like familial hyperaldosteronism type I and II which may cause both glands to be hyperactive.