Hyperaldosteronism involves excessive production of which hormone?

• A. Epinephrine
• B. Aldosterone
• C. Cortisol
• D. Atrial natriuretic peptide

Answer: (B)

Hyperaldosteronism is about overproduction of aldosterone, the mineralocorticoid from the adrenal cortex. Aldosterone acts on the distal nephron to increase sodium reabsorption and potassium (and hydrogen ion) excretion, which raises blood volume and pressure. The excess aldosterone causes hypertension with hypokalemia and a metabolic alkalosis. Normally aldosterone is regulated by the renin–angiotensin system and potassium levels, but in primary hyperaldosteronism the gland secretes it autonomously (often from an adrenal adenoma or bilateral hyperplasia) with inappropriately high levels and relatively low renin. The other hormones listed don’t drive this condition: epinephrine is a medullary hormone for sympathetic effects, cortisol is a glucocorticoid, and atrial natriuretic peptide actually promotes sodium loss and counteracts aldosterone.