Mineralocorticoid hypertension due to hyperaldosteronism and hyperdeoxycorticosteronism

Hypermineralocorticoid hypertension is usually due either to aldosterone or deoxycorticosterone excess. Only in hyperaldosteronism due to adenoma or primary adrenocortical hyperplasia is cure achieved by surgery. Idiopathic hyperaldosteronism may be due to different aldosterone stimulators not related to hypertension. Rare adrenocortical tumours (benign or malignant) producing hyperdeoxycorticosteronism have suppressed aldosterone and in malignancy, cortisol. They provide evidence for a separate non-adrenocorticotrophic regulator of the deoxycorticosterone pathway. The dissociation of normal or reduced cortisol from elevated deoxycorticosterone levels suggests either an adrenal enzymatic disorder or tumour.