I am
Primary aldosteronism – a neglected cause of high blood pressure
heartfoundation.org.au|Helpline 13 11 12

Primary aldosteronism – a neglected cause of high blood pressure

You might already know it’s important to maintain a normal blood pressure to reduce your risk of having a heart attack or stroke.  You might have even had your blood pressure checked recently as part of a Heart Health Check with your GP. 

And if you have high blood pressure, chances are your GP has already told you about some of the things you can do to manage it, like stopping smoking, cutting down on alcohol, and reducing your intake of salty foods. But did you know there are some other less common causes of high blood pressure that often go undetected?

A person’s blood pressure is controlled by a whole range of different mechanisms working together, including your heart, nervous system, kidneys, and certain hormones. One of these hormones is called aldosterone.

Aldosterone is produced by the adrenal glands, which sit on top of each kidney. Its main role is to maintain the salt (sodium) and water balance of the body; it helps the body absorb sodium via the kidneys. This in turn ensures the body can maintain normal blood pressure. For example, if your blood pressure is low, aldosterone will make the body hold onto sodium, which in turn causes the body to retain water. This will help your blood pressure increase back up to a normal level.

Primary aldosteronism is a condition where the adrenal glands produce too much aldosterone, even when the body does not need it. This causes the body to hold onto too much sodium and water, which leads to high blood pressure – which leads to high blood pressure. In addition, aldosterone excess causes a higher risk of stroke and heart attack compared to just high blood pressure alone.

Dr Jun Yang is Head of the Endocrine Hypertension Group at the Hudson Institute of Medical Research and a Senior Research Fellow in the School of Clinical Sciences at Monash University. She is a Heart Foundation Alumni who received a 2017 Vanguard Grant for her research project, Finding a curable cause of high blood pressure.

“A number of studies from overseas indicated that primary aldosteronism is quite common among patients with hypertension.  However, very few doctors actually look for the disease. Without a screening blood test, primary aldosteronism can easily go undetected.”

“My research project, partly funded by the Heart Foundation, was the first one in Australia to explore how many patients may be diagnosed with primary aldosteronism if their GPs proactively screened for the disease.” says Dr Yang.

Her research found that primary aldosteronism is much more common than previously thought in clinical practice.  A survey of general practitioners, completed at the start of the research project, found that less than 0.1% (1 out of 1000) of people with high blood pressure were diagnosed with primary aldosteronism. After screening new patients with a blood test, a much higher proportion were found to have primary aldosteronism.

Dr Yang and her team found that in a staggering 14% of people with high blood pressure who were screened by their GP, the cause was too much aldosterone.

“People aren’t aware, and neither is their GP. This means there are potentially hundreds of thousands of Australians in the community with this condition, which can be diagnosed with a simple blood test,” explains Dr Yang.

The good news is there are already treatments available for primary aldosteronism - either with medicine to block aldosterone, or in some cases, surgery to remove the overactive adrenal gland.

“These findings are important because they demonstrate how we can identify and treat more people with high blood pressure effectively, and potentially save more lives from the devastating impacts of heart attack and stroke,” says Dr Yang.

Dr Yang was also a Chief Investigator on a Heart Foundation 2018 Vanguard Grant investigating the levels of aldosterone in adolescents and young adults.  

“So far, we have been able to establish a link between blood pressure and aldosterone levels even from an early age. There are also clear differences between the sexes. Down the track, this may help us to understand how we might need to tailor our diagnostic tests and treatment to young women and men,” explains Dr Yang.

Dr Yang is currently working on establishing the prevalence of primary aldosteronism in a larger community-based population and identifying biomarkers to detect the condition as early as possible.  She is also evaluating how cardiovascular disease risk is affected by primary aldosteronism, especially in relation to existing cardiovascular disease risk calculators (like the Heart Age Calculator). 

“Primary aldosteronism appears to be a condition that is flying under our radar. It’s not a new disease and the good news is effective medicines are already available to treat it. Primary aldosteronism is very simple to test for and relatively inexpensive to treat. We just need to put better systems in place to look for it.”  

You might also be interested in

The Heart Foundation Alumni Program

The Heart Foundation Alumni Program

The Heart Foundation Alumni Program

Stay connected with your research alumni community. ...

Research Directory

Research Directory

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

FACILITATING INTERNATIONAL CLINICAL TRIALS ...

2020 Strategic Grant Recipients

2020 Strategic Grant Recipients

Heart Foundation Research Award Recipients

Heart Foundation Research Award Recipients

Explore our research award recipients and projects...

Research funding programs

Research funding programs

Research funding programs

Understand the application process and requirements of our various funding programs....

2022 Collaboration and Exchange Award

2022 Collaboration and Exchange Award

Our research stories

Our research stories

Our research stories

We fund amazing researchers who have important stories to tell...

Managing your funding

Managing your funding

Managing your funding

Resources to help manage your grant, scholarship or fellowship....

2022 Future Leader Fellowship

2022 Future Leader Fellowship

Future Leader Fellows are emerging leaders – the best and brightest in cardiovascular research....

Environment, climate change and heart health

Environment, climate change and heart health

Environment, climate change and heart health

Information on how air pollution, heatwaves and bushfires can impact heart health, and what you can do to look after yourself. ...

Heart Health Check Toolkit

Heart Health Check Toolkit

Heart Age Calculator

Heart Age Calculator

Heart Age Calculator

Could you be at risk of heart disease? Get your estimated heart age now....

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

GLOBAL CARDIOVASCULAR RESEARCH FUNDERS FORUM

FACILITATING INTERNATIONAL CLINICAL TRIALS ...

What is angina?

What is angina?

What is angina?

Angina is a type of chest pain or discomfort that’s a symptom of an underlying heart problem, usually coronary heart disease (CHD)....

One pot green goodness pasta

One pot green goodness pasta

One pot green goodness pasta

15 minutes
Serves 2

Q&A with Dr Dean Picone

Q&A with Dr Dean Picone

Q&A with Dr Dean Picone

Key Statistics: Risk Factors For Cardiovascular Disease

Key Statistics: Risk Factors For Cardiovascular Disease

Absolute CVD risk charts

Absolute CVD risk charts

Absolute CVD risk charts provide a visual tool to calculate CVD risk for use in practice in Australia....

Physical activity in the workplace

Physical activity in the workplace

Physical activity in the workplace

Resources to help you create a more physically active workplace....

Learning to listen to your heart

Learning to listen to your heart

Learning to listen to your heart

Guest blog by Heart Foundation of Australia Group CEO, Adjunct Professor John G Kelly AM...

Heart Health Network

Heart Health Network

Heart Health Network

Heart Health Network is the Heart Foundation’s newsletter for health professionals delivered to your inbox once a month....

What is atrial fibrillation?

What is atrial fibrillation?

What is atrial fibrillation?

Atrial fibrillation is a type of arrhythmia where your heart beats irregularly and fast....

Heart attack recovery – quit smoking

Heart attack recovery – quit smoking

Heart attack recovery – quit smoking

Smoking is a major risk factor for heart disease. Get the facts on quitting and how it can help you recover. ...

Heart failure clinical resources

Heart failure clinical resources

Resources and clinical information for health professionals...

Breakfast recipes

Breakfast recipes

Breakfast recipes

Heart healthy breakfasts to start your day right...

Sorting out your finances after a heart attack

Sorting out your finances after a heart attack

Sorting out your finances after a heart attack

Explore how to manage your financial concerns after a heart attack. ...

Our Annual Reports

Our Annual Reports

Our Annual Reports

Discover our Annual reports from 2013 onwards. ...

Dinner recipes

Dinner recipes

Dinner recipes

Search our heart healthy dinner recipes for tonights main meal...

Research connect newsletter

Research connect newsletter

Research connect newsletter

The Research Connect Newsletter provides monthly updates on the Heart Foundation Research Program....

Tahini tofu dressing

Tahini tofu dressing

Tahini tofu dressing

What is a cardiac arrest?

What is a cardiac arrest?

What is a cardiac arrest?

With immediate help a cardiac arrest can be survived. Learn how to save a life....

Acute coronary syndromes (ACS) clinical resources

Acute coronary syndromes (ACS) clinical resources

Resources and clinical information for health professionals...

What is cardiac rehab?

What is cardiac rehab?

What is cardiac rehab?

Cardiac rehab is proven to keep you out of hospital and reduce your risk of death from heart conditions....

Heart Healthy Dinner Plan

Heart Healthy Dinner Plan

Heart Healthy Dinner Plan

Sign up now and discover delicious, easy to follow dinner recipes. Plus shopping lists, tips and other helpful information to make healthy eating easy. ...

Create your fundraiser at Do it for Heart

Create your fundraiser at Do it for Heart

Create your fundraiser at Do it for Heart

Become a Heart Foundation fundraiser, do it for heart and make a real difference to your community....

How can I set and achieve goals to improve my heart health?

How can I set and achieve goals to improve my heart health?

How can I set and achieve goals to improve my heart health?

Question of the month blog...

Fundraise to save Australian hearts

Fundraise to save Australian hearts

Fundraise to save Australian hearts

Join our community of fundraisers who are committed to taking action to fight heart disease....

For professionals: Cardiovascular disease risk assessment for Aboriginal and Torres Strait Islander peoples 

For professionals: Cardiovascular disease risk assessment for Aboriginal and Torres Strait Islander peoples 

Recommendations for assessing Cardiovascular disease (CVD) risk in Aboriginal and Torres Strait Islander peoples ...

Taking your heart medicines

Taking your heart medicines

Taking your heart medicines

Know what your heart medicines are for and how to take them. ...