True about primary aldosteronnism –
**Core Concept**
Primary aldosteronism is a disorder of the adrenal glands characterized by the excessive production of aldosterone, a steroid hormone that regulates electrolyte balance and blood pressure. This condition leads to hypertension and hypokalemia due to the mineralocorticoid effects of aldosterone.
**Why the Correct Answer is Right**
Primary aldosteronism can be caused by either bilateral adrenal hyperplasia or the presence of one or more aldosterone-producing adenomas (APAs) in the adrenal glands. The excessive production of aldosterone stimulates sodium retention and potassium excretion, leading to hypertension and hypokalemia. The renin-angiotensin-aldosterone system (RAAS) is often suppressed in primary aldosteronism, as the high levels of aldosterone feedback inhibit the production of renin.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because primary aldosteronism is not primarily caused by a deficiency of aldosterone.
**Option B:** This option is incorrect because primary aldosteronism is not characterized by an overproduction of cortisol.
**Option C:** This option is incorrect because primary aldosteronism is not a result of a genetic mutation affecting the renin-angiotensin-aldosterone system.
**Clinical Pearl / High-Yield Fact**
It is essential to remember that primary aldosteronism is a common cause of secondary hypertension, and patients with this condition often present with hypertension and hypokalemia. A diagnosis of primary aldosteronism can be confirmed by demonstrating an inadequate suppression of aldosterone production in response to a low-sodium diet.
**Correct Answer:** D