High blood pressure cure? For some, this treatment is not a conn

Short Version/TLDR

I used to have persistent high blood pressure (HBP) that was referred to as "essential hypertension," but now I don't. 
  • If you have HBP and low potassium, check out Conn's syndrome, also known as Primary Aldosteronism or PA. 
  • If you have PA/Conn's syndrome, an operation can fix it. 
  • I had the op in 2013 when my BP was 150/100 while on HBP meds. 
  • At the end of 2013 my blood pressure was 120/70 w/out meds, and it still is.

Why am I re-sharing this information?

I wrote about my experience with Conn's syndrome back in 2013. This blog post is simply a re-sharing of what I wrote back then (with one new piece of data at the end).

Why am I doing this? Every time I hear a person say "I have high blood pressure" or HBP, my thoughts go like this:
  • I know what HBP is like.
  • HBP is not very nice.
  • HBP can shorten your life.
  • I am extremely fortunate that I don't have HBP any more.
  • Should I tell this person about Conn's syndrome?
Of course, the answer to the "should I tell" question depends on a range of variables: who is the person saying they have high blood pressure? Where is this being said? Do I know this person? I try to weigh these variables before speaking, but as people who know me will tell you, I tend to err on the side of speaking up, sometimes to strangers. I also have a tendency to speak up about some things that other people might prefer to keep private.

However, a fair number of people have thanked me for sharing the story of my battle with high blood pressure because they found it helpful. And that is why I wrote about my experience, so people could "read all about it" if they wanted to, rather than listen to me talk about it.

So here are the relevant blog posts in historical order (as in earliest first - I am not suggesting that these articles are 'historic'):

What now?

I always intended to write one more blog post on this topic, documenting the long-term prognosis and perhaps adding some references. I guess this is that 'one more' blog post. Sadly, I don't have time to do a full reference list but this article on Conn's syndrome is quite helpful, as is this more technical paper). Also check out the Primary Aldosteronism Foundation website.

My sense from reading the literature is that there will be many more cases like mine: people cured of their HBP, often after years of being told that their HBP had no known cause and they just weren't eating and living right. These people will be identified by: [a] continual improvements in ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI); and hopefully [b] greater awareness of Conn's / Primary Aldosteronism.

The summer of 2018 marked the five year anniversary of the operation that returned my blood pressure to 'normal' without drugs. It has been a busy five years. I started a masters degree in late 2014 and graduated in 2016, all while carrying a very full workload (from an employer wise enough to subsidize graduate school tuition).

For the most part I have felt pretty healthy. There have been some issues with my digestive system and I sometimes wonder if they are a lingering side effect, not of the adrenalectomy itself, but the infection I got during my hospital stay. 

Nevertheless, that operation was well worth it and I feel very fortunate that—thanks again to a wise employer—my health insurance covered it. I am reminded that it is in the national interest for everyone to have access to affordable healthcare, so that the negative economic impact of conditions like HBP can be reduced by more efficient diagnosis and treatment.

The sting in the tale

An update from late 2019: my adrenalectomy did not cure my atrial fibrillation, which was probably caused by the excess aldosterone in my body during all those years in which my primary aldosteronism went undiagnosed. 

Sadly, "the current diagnosis of primary aldosteronism is suboptimal–its delayed diagnosis results in end-organ damage that requires complex management...an increased awareness of primary aldosteronism is required in both primary and tertiary care so that an earlier diagnosis can be made for optimal patient outcomes." That's from a 2018 article in the Australian Journal of General Practice published by the Royal Australian College of General Practitioners (here's a link to the article).

All the more reason to let more people with high blood pressure know about Conn's syndrome / Primary Aldosteronism, so they can ask their doctors to investigate, before excess aldosterone has a chance to do lasting damage.

One of these days I will write about how many doctors and cardiologists missed the classic symptoms of my primary aldosteronism, and how I feel about that. In the meantime, I will keep telling people that there may be a cure for their "essential hypertension."