Adrenal Tumors Causing High Blood Pressure (Hypertension)

High Blood Pressure (Hypertension) Caused by Adrenal Tumors

Hypertension or high blood pressure (HBP) is one of the most common diseases in the world and many people have it because of an adrenal tumor and they don't even know it. High blood pressure is the major risk factor for stroke, heart disease and heart arrhythmias. It is estimated that almost a quarter (25%) of the entire world’s population has hypertension. That means about 1 billion adults. In the United States, it is estimated that about one in four (about 75 million) adults have high blood pressure or is taking antihypertensive medications. A normal systolic blood pressure is between 90 to 129 mmHg whereas a diastolic pressure should be between 60 and 79 mmHg.

Can high blood pressure be cured? YES. Since many patients with high blood presure have an adrenal tumor as the cause, yes, removing the adrenal tumor can improve and often completely cure the high blood pressure. Learn about how a short Mini Back Scope Scope Adrenalectomy (MBSA) operation can potentially cure you of high blood pressure and thereby decrease your chance of stroke, heart attack, and sudden death.

Classification of Types of Hypertension (High Blood Pressure)

Type	Systolic	Diastolic
Normal	Less than 120	Less than 80
Pre-Hypertension	120 - 139	80 -90
Stage 1 Hypertension	140 - 159	90 -99
Stage 2 Hypertension	160 - 179	100 -109
Hypertensive Crisis	Over 180	Over 110

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Hypertension is a difficult problem because it is rarely accompanied by symptoms. That means that the patient is asymptomatic and unless they have their blood pressure checked they will not know that there they are hypertensive. However, if symptoms occur it can be reported as headaches, lightheadedness, vertigo, tinnitus (ringig of the ears), altered vision or even fainting.

Primary Hypertension. In most cases, high blood pressure is due to what we call "primary hypertension". This means that there is no underlying cause of the high blood pressure. This is sometimes also called "essential hypertension". Primary hypertension is the most common form of high blood pressure and it can only be treated with medications and life-style modifications (the usual recommendations, exercise, loose weight, stop smoking and eat a healthy diet).

Secondary Hypertension. Secondary hypertension means that there is an identifiable cause that is underlying the high blood pressure. In other words, patients with secondary hypertension have something causing it--and often this is an adrenal tumor. In these cases, hypertension can be cured, often with a safe and straightforward Mini Back Scope Scope Adrenalectomy (MBSA) This is why it is very important for doctors to not just treat the high blood pressure with medications without figuring out why the patient has high blood pressure in the first place.

Adrenal Tumors are the Most Common Cause of Secondary Hypertension

The most common cause of secondary hypertension has to do with adrenal hormones, and tumors that overproduce these hormones. This is what is called "endocrine hypertension" ("endocrine" means hormone). This is high blood pressure due to an adrenal tumor. It is estimated that 15% of all cases of high blood pressure are due to an underlying adrenal tumor problem. This means that there are about 10 million patients in the United States that suffer from this problem! Unfortunately, only a minute fraction of these patients is correctly diagnosed, treated and referred for possible curative surgery (adrenalectomy). Dr. Carling is passionate about changing this during his life-time. It is not acceptable that many thousands of patients are sick and die prematurely due to an andrenal tumor which often can be cured in less than 30 minutes. We need to do a better job diagnosing these patients by improving knowledge about the toxic effects of adrenal tumors and screening for them.

High blood pressure categories. Patients with high blood pressure need to be screened for an adrenal tumor.

All 4 classes of adrenal hormones can cause high blood pressure. These 4 classes of adrenal hormones are: 1) aldosterone, 2) cortisol, 3) catecholamines, and 4) sex-steroid hormones. Overproduction of all of these hormones can cause secondary hypertension. That means primary hyperaldosteronism (Conn's syndrome), Cushing’s syndrome, pheochromocytomas and sex-steroid hormone-producing tumors are all associated with hypertension.

Interestingly, each of the different adrenal hormones causes slightly different types of hypertension and with different symptoms. For instance, patients with Cushing’s syndrome due to an adrenocortical tumor overproducing cortisol have sustained relatively mild to moderate hypertension. Patients with a tumor overproducing aldosterone typically causes sustained moderate to high hypertension, sometimes where the diastolic is worse than the systolic pressure. Patients with a pheochromocytoma (or paraganglioma) may have completely normal baseline blood pressure but then have abrupt episodes (paroxysmal) of very severely elevated blood pressure often together with headaches, palpitations, pallor (pale face) and sweating.

Important information: Most, but not all patients with primary hyperaldosteronism (Conn's tumor), Cushing’s syndrome, and pheochromocytoma have baseline hypertension. In fact, almost half of patients with pheochromocytoma or paraganglioma are normotensive (meaning having normal blood pressure) during large parts of the day.

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Who Should be Tested for Adrenal Tumor as Cause of High Blood Pressure?

If you belong to any of these groups of patients with hypertension you need to make sure you do not have an adrenal tumor that is causing your high blood pressure:

• Resistant hypertension (i.e. poor response to medications)
• Hypertension requiring two or more blood pressure medications
• Hypertension requiring being on Spironolactone (Aldactone), Eplerenone (Inspra) or Amiloride
• Hypertension of any grade, without known risk factors such as age, smoking. kidney problems, diabetes, obesity, etc
• Hypertension at a young age (< 50 years of age)
• Hypertension with low blood potassium (hypokalemia) (this is classic for Conn's Syndrome).
• Hypertension with an adrenal incidentaloma (adrenal tumor found when x-raying for something else)
• Hypertension and sleep apnea
• Hypertension and a family history of early-onset (< 50 years of age) hypertension or stroke at a young age
• Hypertension in a family with any family member with an adrenal tumor (whether a Conn's Syndrome tumor, Cushing’s Syndrome, or pheochromocytoma/paraganglioma)
• Hypertension that is episodic - it comes and goes (paroxysmal)

Important to know! There are other causes of secondary hypertension not related to the adrenal gland. One such disease is primary hyperparathyroidism, due to one or more parathyroid tumors. Please review parathyroid glands, hyperparathyroidism and parathyroid surgery at our sister page . Endocrine hypertension can also be caused by diseases of the thyroid gland. Learn about thyroid tumors, thyroid cancers, and thyroid surgery here. Other rarer causes of secondary hypertension include those related to changes in the major blood vessels in your body.