The symptoms are non-specific, but rarely present with tetany, muscle weakness, nocturia, or polyuria.

Causes: –

1. Adrenal adenoma
2. bilateral adrenal hyperplasia (BAH)
3. Familial hyperaldosteronism
4. Adrenal carcinoma

Classic features: –

1. Hypertension
2. Hypokalaemia < 3.5 mmol/L (although 70% of patients may be normokalaemia)
3. Metabolic alkalosis
4. Sodium may be normal or at the high end of normal.

Investigations: –

1. Spot renin and aldosterone levels – Raised aldosterone levels and low renin.
2. U&Es – may show hypokalaemia and hypernatraemia.
3. ECG – may show arrhythmias from electrolyte imbalance.
4. Renal & adrenal CT/MRI scans

Management: –

1. Dietary sodium restriction.‎
2. Lifelong mineralocorticoid receptor antagonists for patients with bilateral ‎primary aldosteronism e.g., spironolactone and eplerenone
3. Surgical adrenalectomy is the treatment of choice for patients with unilateral primary aldosteronism who are healthy enough to undergo the surgery.