**Core Concept**
Primary hyperaldosteronism is a clinical condition characterized by an excessive production of aldosterone, a mineralocorticoid hormone produced by the adrenal glands. This leads to sodium retention, potassium excretion, and hypertension. The underlying cause is usually an aldosterone-producing adenoma (APA), bilateral adrenal hyperplasia, or familial hyperaldosteronism.

**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of primary hyperaldosteronism. Aldosterone acts on the collecting ducts of the kidneys to promote sodium reabsorption and potassium excretion. In primary hyperaldosteronism, the excessive aldosterone production leads to an increase in sodium reabsorption, resulting in volume expansion and hypertension. The renin-angiotensin-aldosterone system (RAAS) is also activated, further increasing aldosterone production.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because primary hyperaldosteronism is indeed associated with hypernatremia and hypokalemia due to excessive sodium reabsorption and potassium excretion.
**Option B:** This option is incorrect because primary hyperaldosteronism is characterized by hypertension, not hypotension, due to volume expansion and vasoconstriction.
**Option C:** This option is incorrect because primary hyperaldosteronism is associated with an increased risk of cardiovascular disease, including left ventricular hypertrophy and coronary artery disease, not a decreased risk.

**Clinical Pearl / High-Yield Fact**
Primary hyperaldosteronism is a common cause of secondary hypertension in patients under the age of 40. It is essential to consider this diagnosis in young patients with resistant hypertension, particularly those with hypokalemia and alkalosis.

**Correct Answer: D**