# A Case Report of Primary Aldosteronism and Extensive Hypertension-Mediated Organ Damage

## TL;DR

A 41-year-old man with undiagnosed primary aldosteronism suffered severe organ damage due to uncontrolled high blood pressure, highlighting the need for early diagnosis.

## Contribution

This case report emphasizes the severe consequences of untreated primary aldosteronism and the importance of timely diagnosis.

## Key findings

- The patient had extensive hypertension-mediated organ damage, including stroke and kidney failure.
- An elevated aldosterone/renin ratio and adrenal hyperplasia confirmed primary aldosteronism.
- The case underscores the risks of undiagnosed secondary hypertension in young adults.

## Abstract

Primary aldosteronism, the most common curable form of secondary hypertension, is associated with greater hypertension-related organ damage and cardiovascular complications compared to primary essential hypertension.

The authors present a case involving a 41-year-old Black male admitted to the emergency department with left hemiparesis and blurred vision persisting for one hour, accompanied by markedly elevated blood pressure (220/140 mmHg). The patient was asymptomatic by then, and, aside from a history of tobacco smoking and occasional cannabis use, lacked significant medical comorbidities. Further investigations revealed a right acute hemorrhagic stroke, bilateral grade 4 hypertensive retinopathy, chronic kidney disease with end-stage renal disease, hypokalemia, and an elevated aldosterone/renin ratio. An abdominal CT scan showed bilateral adrenal hyperplasia. The patient was diagnosed with primary aldosteronism with extensive hypertension-mediated organ damage.

This case highlights the significant harm caused by undiagnosed primary aldosteronism-induced secondary hypertension, emphasizing the importance of timely diagnosis and intervention to prevent organ damage.