Doctors Warn Up to 30% of People With High Blood Pressure Have This Undiagnosed Condition
Hypertension is primarily linked to unhealthy lifestyle factors, including excessive drinking, smoking, lack of exercise, and a diet high in fat and sodium. Alternatively, it might run in your family or be the sign of an underlying condition, such as Cronn’s syndrome. In a new research paper, doctors shed light on a commonly undiagnosed condition that could be the reason why your blood pressure levels are skyrocketing.
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Hypertension could be a sign of this underlying (and commonly undiagnosed) condition.
Endocrine Society experts estimate that between 5 and 14 percent of people with hypertension also have undiagnosed primary aldosteronism, better known as Conn’s syndrome. According to their data, up to 30 percent of hypertension patients in referral centers face the same risk.
An overproduction of the hormone aldosterone can cause high blood pressure. This hormone is responsible for regulating sodium and potassium blood levels, explains Cleveland Clinic. Hypertension is considered “the defining feature” of primary aldosteronism, though other symptoms can include:
- Fatigue
- Excessive thirst
- Frequent urination
- Headache
- Muscle cramps and weakness
- Blurred vision
Doctors warn that primary aldosteronism patients battle “significantly higher health risks,” particularly related to the heart, compared to hypertension patients. Their findings appear in a new Clinical Practice Guideline that was published on July 14 in The Journal of Clinical Endocrinology & Metabolism (JCEM).
“People with primary aldosteronism face a higher risk of cardiovascular disease than those with primary hypertension,” Gail K. Adler, PhD, the paper’s lead author from Brigham and Women’s Hospital and Harvard Medical School in Boston, said in a press release. “With a low-cost blood test, we could identify more people who have primary aldosteronism and ensure they receive the proper treatment for the condition.”
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Individuals with Conn’s syndrome have an increased risk of heart and kidney issues.
The proposed guidelines are the result of two extensive meta-analyses that evaluated over 75 studies.
In the first meta-analysis, the authors assessed health records of 3,838 primary aldosteronism patients and 9,284 primary hypertension patients. They discovered that those with Conn’s syndrome have an increased risk of four cardiovascular conditions, a median of 8.8 years after getting diagnosed with high blood pressure.
The findings were as follows:
- 2.58 greater odds of stroke
- 1.77 greater odds of coronary artery disease
- 3.52 greater odds of atrial fibrillation
- 2.05 greater odds of heart failure
Another meta-analysis concluded that primary aldosteronism patients have an increased risk of renal disease and proteinuria. The authors reviewed health charts of 6,056 individuals with primary aldosteronism and 9,733 with primary hypertension to calculate their findings.
Here’s what they found:
- 2.09 greater odds of chronic kidney disease
- 2.68 greater odds of proteinuria (high amounts of protein in urine, which can be a sign of kidney issues, diabetes, or cardiovascular disease)
Additionally, the authors reported that individuals with primary aldosteronism “often report reduced psychological well-being and quality of life.”
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Despite the increased risk of mortality, doctors don’t regularly screen for primary aldosteronism.
“Despite its prevalence and the serious health risks it poses, primary aldosteronism remains largely underdiagnosed and undertreated,” said the researchers.
But why is that?
According to Adler and her team, “screening for primary aldosteronism is critically low, often delayed until years after hypertension has been diagnosed,” and “typically following the emergence of severe complications.”
“As a result, many individuals continue to be treated for primary hypertension, thus missing out on targeted treatments or potential cures, and enduring suboptimally managed blood pressure and increased risks of cardiovascular and renal disease,” they wrote in the paper.
Primary aldosteronism-caused morbidity and mortality are “largely preventable” with early screening.
The authors referenced the 2024 European Society of Cardiology (ESC) as an appropriate guidepost. Under their guidelines, it’s recommended that all adults with diagnosed hypertension also get screened for primary aldosteronism.