Harvard Heart Letter

Aldosteronism: Too much of a good thing

The hormone aldosterone helps the body manage water and sodium. Too much of it is an overlooked cause of high blood pressure.

Although we often talk about high blood pressure as if it were a disease, it really isn't. It is a symptom of trouble somewhere in the body. High blood pressure usually accompanies excess weight, declining kidney function, and arteriosclerosis, the narrowing and stiffening of blood vessels. One often overlooked cause of high blood pressure is a malfunction of the adrenal glands.

The adrenals (once called the suprarenals) are triangular glands that perch atop each kidney. They churn out hormones that affect the stress response and the immune system. They also make aldosterone. This hormone helps manage the body's balance of water, sodium, and potassium. Too much aldosterone makes the kidneys hang on to sodium and water and flush potassium into the urine. The extra fluid ends up in the bloodstream. This forces the heart to push harder to propel blood on its journey through thousands of miles of blood vessels, which raises blood pressure. Overproduction of aldosterone is known as aldosteronism.

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