Which electrolyte abnormality is most associated with hyperaldosteronism causing secondary hypertension?

Which electrolyte abnormality is most associated with hyperaldosteronism causing secondary hypertension?

• A. Hypernatremia
• B. Hypokalemia
• C. Hyperkalemia
• D. Hyponatremia

Answer: (B)

Hyperaldosteronism drives Na+ reabsorption in the distal nephron while increasing K+ secretion. Aldosterone acts on principal cells to upregulate ENaC channels and Na+/K+ ATPase, leading to more sodium and water reabsorption (expanding volume and raising blood pressure) and simultaneous potassium loss into the urine. The net result is hypokalemia, the classic electrolyte pattern seen with aldosterone excess and secondary hypertension. While sodium may be normal or mildly elevated and occasional alkalosis can occur, the defining abnormality here is low potassium.

Hyperaldosteronism drives Na+ reabsorption in the distal nephron while increasing K+ secretion. Aldosterone acts on principal cells to upregulate ENaC channels and Na+/K+ ATPase, leading to more sodium and water reabsorption (expanding volume and raising blood pressure) and simultaneous potassium loss into the urine. The net result is hypokalemia, the classic electrolyte pattern seen with aldosterone excess and secondary hypertension. While sodium may be normal or mildly elevated and occasional alkalosis can occur, the defining abnormality here is low potassium.