Let's learn about Aldosterone, which secretly affects your blood pressure.

A problem that many people in Sri Lanka have is high blood pressure. For some, it is very difficult to control this even after taking medication. But there is someone inside our bodies that we don't talk about much, but secretly influences blood pressure. That is what we are going to talk about today. His name is Aldosterone.

Simply put, who is this aldosterone?

Aldosterone is a hormone in our body. Hormones are like the postmen in our body. They carry messages to each organ, telling it to do this, stop that.

So this hormone called aldosterone is made by two small triangular glands that are like a cap on top of our kidneys. We call these the adrenal glands. These glands are part of our endocrine system.

The main job of this hormone is to keep our blood pressure at the right level . It does this by controlling the levels of minerals in our blood called sodium (that's salt) and potassium. These sodium and potassium are two types of electrolytes . They are the ones that keep the body's fluid levels balanced and help nerves and muscles work properly.

How does aldosterone control blood pressure?

This is a very interesting process. Aldosterone mainly affects blood pressure in the following ways:

1. Sodium Retention: Aldosterone signals our kidneys and colon to "add more sodium (salt) to the blood and increase the amount of potassium excreted in the urine."

2. Water retention: When sodium is added to the blood, water is also retained in the body. It's like water is attracted to salt.

3. Increased blood volume: When we retain water in our bodies, our total blood volume increases. Just as filling a water pipe with more water increases its pressure, when blood volume increases, blood pressure also increases.

In this way, when our blood pressure drops, aldosterone steps in and helps bring it back to a healthy level. This hormone also indirectly helps regulate the pH (i.e., acid-base balance) and electrolyte levels of the blood.

How are these aldosterone levels controlled? - An amazing process!

Aldosterone doesn't work alone. It's part of a team that works together. We call this system the Renin-Angiotensin-Aldosterone System (RAAS) . It's like a relay race.

Think about it this way.

• First step: Your blood pressure (BP) drops. Our kidneys sense this. The kidneys then release an enzyme called renin into the blood.
• Step two: This renin goes and breaks down a protein called angiotensinogen, which is made by our liver, into a piece called angiotensin I. But it's still dormant, which means it doesn't have much power.
• Step Three: Now, as this angiotensin I travels through the bloodstream, it is broken down by the angiotensin-converting enzyme (ACE) from our lungs, creating a very powerful hormone called angiotensin II . This is the real hero.
• Step Four: This angiotensin II does two main things.

1. It causes the small blood vessels (arterioles) to constrict. This causes blood pressure to increase immediately.

2. It goes to the adrenal glands and tells them, "Emergency! Quickly produce aldosterone!"

• The final step: Now aldosterone comes in and tells the kidneys to retain salt (sodium) and water and excrete some potassium. This increases blood volume and returns blood pressure to normal.

Once this entire process is complete, and blood pressure returns to normal, this system automatically shuts down. This is a very complex, but very wonderful control system.

How are aldosterone levels measured?

If your doctor is having trouble controlling your blood pressure, or if you have changes in your blood potassium levels, he or she may suspect aldosterone. The main test for this is the aldosterone:renin ratio test .

Because aldosterone and renin work together, measuring the levels of both can help pinpoint the exact location of the problem. This is usually done by taking a small amount of blood from a vein in your arm.

In addition, aldosterone levels can be measured separately in blood or urine collected over 24 hours.

What happens if aldosterone levels increase?

When the level of aldosterone in the body is higher than normal, we call it hyperaldosteronism . The main cause of this is a condition called primary aldosteronism . This is also called Conn's syndrome .

This condition is often caused by a small, non-cancerous (benign) tumor that develops in an adrenal gland. This tumor causes the gland to produce too much aldosterone. This causes an increase in sodium (salt) in the blood, a decrease in potassium, and an electrolyte imbalance.

What happens if aldosterone levels decrease?

Also, when the level of aldosterone in the body is lower than normal, we call it hypoaldosteronism . This is when the aldosterone hormone is produced too little or its function is impaired. This can cause low sodium (salt) levels in the blood, high potassium levels, and a condition called metabolic acidosis (increased acidity in the blood) .

What are the reasons for this?

• Addison's disease: This is a rare autoimmune disease. This means that the body's own immune system turns against itself and damages the adrenal glands. This results in a decrease in the production of both the hormones aldosterone and cortisol.
• Congenital Adrenal Hyperplasia (CAH): This is a genetic condition that is present at birth. It causes deficiencies in certain enzymes needed to make hormones in the adrenal glands.
• Other medical conditions: This condition can occur in people with diabetes, kidney disease, and those who are seriously ill.
• Some medications: This condition can also be caused by painkillers (NSAIDs) , blood thinners like heparin, and some heart medications.

If you have these symptoms, it is very important to make an appointment to see your doctor and talk about this.

Aldosterone, high blood pressure, hormones, kidneys, sodium, potassium, blood pressure