Hypertensive Urgency With Primary Hyperaldosteronism Due to Unilateral Idiopathic Adrenal Hyperplasia: A Case of Headache With Severe Hypokalemia in a Young Male

Cureus. 2024 Nov 25;16(11):e74461. doi: 10.7759/cureus.74461. eCollection 2024 Nov.

Abstract

Hypertension remains a significant global health issue, increasingly affecting younger populations due to lifestyle and dietary changes. This case report presents a 28-year-old male diagnosed with primary hyperaldosteronism, a rare but treatable cause of secondary hypertension, presenting as hypertensive urgency. The patient reported persistent headaches and weakness, with an initial blood pressure of 190/120 mmHg and severe hypokalemia. Through a systematic diagnostic approach, including biochemical and imaging assessments, unilateral adrenal hyperplasia was identified as the cause of primary hyperaldosteronism. Targeted treatment, including antihypertensive agents, potassium supplementation, and mineralocorticoid receptor antagonists, led to significant improvements in blood pressure and electrolyte levels. This case underscores the importance of considering secondary hypertension causes in young adults and the potential for positive outcomes with accurate, resource-conscious diagnostic and management strategies.

Keywords: adrenal hyperplasia; adrenal imaging; aldosterone excess; electrolyte imbalance; hypertension; hypokalemia; mineralocorticoid antagonist; potassium supplementation; targeted treatment; young hypertensive.

Publication types

  • Case Reports