2024-03-17 12:40:51
High blood pressure can indicate Conn syndrome. However, targeted tests are necessary for a reliable diagnosis, such as measuring the aldosterone level.
Anyone who has high blood pressure and finds that classic antihypertensive medications do not help or hardly help, should get to the bottom of the cause. The so-called Conn syndrome may be behind it. With this disease of the adrenal glands, an excess of the messenger substance aldosterone occurs in the body, which increases blood pressure.
Conn syndrome – the first step to diagnosis
If Conn syndrome is suspected, a blood test is usually carried out first. The doctor usually determines the so-called aldosterone-renin quotient, i.e. the ratio of the aldosterone to the renin concentration in the blood.
Renin is a substance produced by the kidneys that helps regulate blood pressure. It is released whenever blood pressure falls and then helps it rise again. Among other things, it causes the adrenal glands to produce more aldosterone.
Aldosterone, in turn, is a hormone produced by the adrenal glands that is involved in the regulation of water and salt balance and can increase blood pressure: If the aldosterone level increases, the kidneys absorb more sodium from the urine. Sodium, in turn, “pulls” water with it. The greater the water content of the blood, the higher its volume – and consequently the blood pressure.
In Conn syndrome, aldosterone levels are increased. At the same time, the renin level is reduced. An increased aldosterone-renin ratio is therefore considered a sign of Conn syndrome.
A notice: Before the blood test, patients are usually instructed to avoid licorice for four weeks and to stop taking certain antihypertensive medications. Both licorice and the medicines can distort the measurement results.
Further tests confirm the diagnosis
The doctor can carry out further examinations to confirm this. One way to confirm the diagnosis is a saline stress test.
The patient receives two liters of saline solution via an infusion within four hours. The high salt and fluid intake causes blood pressure to rise. A healthy body would then temporarily suppress the production of aldosterone (which increases blood pressure) in order to ensure balance.
In a person with Conn syndrome, however, the aldosterone level does not fall as much as would be expected because the regulation of aldosterone production is disrupted. There can be various reasons for this. This also needs to be clarified as part of the diagnostics. The treatment of Conn syndrome must be based on the exact cause.
Conn syndrome can have different causes
To determine the cause of the aldosterone excess, the doctor will examine the adrenal glands using imaging techniques such as computer tomography and/or magnetic resonance imaging. For example, benign and malignant tumors of the adrenal glands can be identified, which can be the cause of Conn syndrome.
In some of those affected there is no tumor, but rather the adrenal cortex, which is responsible for aldosterone production, is enlarged. The doctor will also pay attention to such an enlargement when evaluating the CT or MRI images.
Conn syndrome – what the diagnosis means
Early treatment is very important for Conn syndrome because otherwise high blood pressure becomes a significant risk to cardiovascular health.
If an enlarged adrenal cortex is the cause, treatment usually involves a medication called spironolactone. This is an aldosterone inhibitor, i.e. an agent that ensures that aldosterone can no longer develop its effect.
If taking spironolactone is not enough to bring blood pressure to a healthy level, those affected usually also receive antihypertensive medication.
If Conn syndrome is caused by a benign tumor of the adrenal glands, the doctor may recommend surgically removing the affected adrenal gland in order to lower blood pressure.
Good to know: However, the procedure does not always normalize blood pressure, but only in around half of those treated. As has been shown, the prospects of recovery depend on various conditions. The chances are particularly good for female patients who have lived with high blood pressure for less than six years before the operation and whose body mass index is below 25.
For some sufferers, surgery is not an option. Then medication for high blood pressure is also necessary.
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