Hidden hormone problems may be driving your high blood pressure

High blood pressure, or hypertension, used to be considered an issue for people over 40. But today, more young adults in their 20s and 30s are being diagnosed. Many assume stress, too much caffeine, or long working hours are the reasons. However, experts say there can be another cause—a hidden hormone disorder called Primary Aldosteronism (PA).

Dr Sweta Budyal, Senior Consultant in Diabetology and Endocrinology at Fortis Hospital, Mulund, explains that PA is underdiagnosed, yet treatable. “We see younger patients whose blood pressure does not respond to usual medication. Often, the cause is a hormone imbalance rather than stress,” she says.

Primary Aldosteronism happens when the adrenal glands, small organs above the kidneys, make too much aldosterone. This hormone regulates sodium and potassium levels in the body. Too much aldosterone causes sodium retention and potassium loss, leading to severe and hard-to-control high blood pressure.

Studies show that 5–10% of all hypertension cases, and up to 20% of resistant hypertension cases, may be caused by PA. Despite this, most people are unaware of the condition.

Why young adults need testing

India’s young population faces health risks from irregular sleep, processed foods, and stress. If high blood pressure develops before age 40, especially if it does not improve with medicine, doctors recommend testing for hormonal causes. Low potassium levels, muscle weakness, or a family history of early hypertension or stroke are other warning signs.

“Detecting Primary Aldosteronism early can completely change treatment and prevent serious complications,” Dr Budyal notes. Untreated PA can quietly damage the heart, blood vessels, and kidneys. It increases the risk of heart attack, stroke, arrhythmia, and kidney disease. Many young people assume standard blood pressure medicine is enough, delaying proper diagnosis.

The good news is that PA is treatable. Blood and urine tests measuring aldosterone and renin levels can confirm the condition. In many cases, medications that block aldosterone can control blood pressure effectively. If a benign adrenal tumor is responsible, minimally invasive surgery can even cure the condition entirely. Early detection often allows blood pressure to return to normal without lifelong medication.

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Doctors advise screening for hormonal causes in people who:

• Develop hypertension before age 40

• Require multiple medicines to control blood pressure

• Have family history of early hypertension or stroke

• Show low potassium without another explanation

Dr Budyal stresses, “Hormonal testing is no longer optional. It can prevent years of silent damage to vital organs.”

Even if lifestyle factors like diet and stress contribute to high blood pressure, sometimes the real cause is hormonal. Recognizing this can save lives, especially for young adults who may otherwise ignore warning signs.

Taking action early—through testing, medication, or surgery—can prevent long-term complications and restore healthy blood pressure. PA reminds us that high blood pressure in young adults is not always just about lifestyle; it can be the body’s way of signaling a deeper problem.