Ppt

2. • Conn syndrome (primary hyperaldosteronism) is a hormonal disorder in
which the adrenal glands produce the hormone aldosterone in excess. It is
manifested by an increase in blood pressure.
• The main task of aldosterone is to regulate the level of sodium and
potassium in the blood. If this hormone becomes too much, the body
begins to lose potassium and retain too much water, which increases
blood volume and blood pressure.
• Primary hyperaldosteronism can be caused by hyperactivity of either one
or both adrenal glands, i.e. be unilateral or bilateral. Unilateral disease is
usually caused by aldosterone-producing adenoma (benign tumor),
hyperplasia (increased cell growth) or, less often, cancer of one adrenal
gland. Genetic factors affect the development of these causes. Bilateral
disease usually causes bilateral hyperplasia, i.e. increased growth of cells
of both glands. The cause of such adrenal hyperactivity can be rare
genetic syndromes: family hyperaldosteronism of type 1 and 2.

3. • Conn syndrome is most common in people 30-50 years old, mainly
among women - in 60-70% of cases. Initially, it was considered an
extremely rare disease. It has now been established that this is one
of the most common causes of symptomatic arterial hypertension.
Recent studies show that this disease occurs in 5-15% of patients
with hypertension. But since patients resistant to the treatment of
arterial hypertension are rarely referred to an endocrinologist for
examination, Conn syndrome seems to often remain undiagnosed.
• Although primary hyperaldosteronism is still a significant diagnostic
problem, its recognition is crucial, since arterial hypertension in this
disease can be completely cured by surgery (as opposed to
hypertension, when patients are forced to take antihypertensive
drugs for life).

4. Symptoms
• High blood pressure is constant and often the only symptom of
primary hyperaldosteronism. It is observed in 75-98% of cases,
causes headaches, blurred vision and dizziness [2][4].
• The increase in blood pressure can be either insignificant or very
high. Moreover, high numbers in Conn syndrome are usually difficult
to control, so patients are forced to take four drugs to reduce blood
pressure or even more.
• Often patients may experience hypertensive crises in which the
upper (systolic) pressure rises above 250 mm Hg [3]. The clinical
picture of such crises in Conn syndrome does not differ from the
usual hypertensive crisis: patients are concerned about headache,
nausea, vomiting, dizziness, flickering of flies in front of the eyes,
excessive sweating, pain in the heart area, rapid pulse, fear, ringing
in the ears, etc.

5. • Hypokalemia (low potassium level in the blood) is the second most frequent symptom of
primary hyperaldosteronism. It is detected in 9.37% of patients [5]. Hypokalemia can cause
symptoms such as fatigue, numbness, frequent urination, thirst, cramps and muscle
weakness. An increase in the volume of urine (polyuria) and night awakenings due to the
urge to urinate (nocturia) are the result of kidney dysfunction. Sometimes hypokalemia
can be caused by taking diuretics. The sodium level in this case can be normal or
moderately elevated. Sedema syndrome, unlike other kidney diseases, is rare.
• All these complaints are common in other diseases. It is Conn's syndrome that can be
suspected if the patient has:
• very high blood pressure, poorly amenable to drug therapy;
• family history of primary aldosteronism;
• high blood pressure under the age of 40;
• high blood pressure and a tumor in one of the adrenal glands;
• high blood pressure and low potassium levels;
• high blood pressure and apnea during sleep.

7. • PA can be familial (hereditary)-
• and sporadic (non-hereditary).
• The family variant of the disease causes one of 4 genetic
variants of hyperaldosteronism, which are inherited. It can also
occur sporadically, i.e. from case to case. Genetic forms of the
disease are associated with gene mutation, sporadic - with the
development of aldosterone-producing adenoma or bilateral
adrenal hyperplasia. Until 2011, the cause of these adenomas
was unknown. Later, doctors found that various mutations also
play a special role in the occurrence of these diseases [14].
• At least 6% of all cases of primary hyperaldosteronism are
inherited.