This Sneaky Hormone Could Be Raising Your Blood Pressure Right Now

When you think of high blood pressure, lifestyle choices around nutrition or exercise may come to mind—not your hormones. But what if we told you there’s a sneaky hormone that could be driving your high blood pressure, one you’ve probably never heard of? It’s true, and it’s called aldosterone. This little-known hormone has been flying under the radar for years, but experts say it could be responsible for about 15 percent of high blood pressure cases. We asked a top cardiologist to break down everything you need to know about aldosterone and high blood pressure, including how to get your levels tested and what you can do about it.

What is aldosterone?

“Aldosterone is a hormone made by the adrenal glands, which sit on top of the kidneys,” saysKardie Tobb, DO, MS, FASPC, FACC, a board‑certified preventive cardiologist and the medical director for the Cone Health HeartCare Women’s Heart Health and Cardio-Obstetrics Clinic for insights. “Its main job is to help regulate blood pressure, sodium, potassium and fluid balance.”

How does aldosterone impact blood pressure?

Dr. Tobb explains that aldosterone tells our kidneys to hold onto both sodium and water while releasing potassium from the body. This process can be helpful when we’re losing a lot of fluids, such as when we’re sick or have a stomach bug. But when aldosterone levels become too high and the body holds onto extra water and sodium when it doesn’t need to, blood pressure can rise, adds Dr. Tobb.

“Beyond simply raising blood pressure, high aldosterone levels can directly damage blood vessels, the heart, kidneys and even contribute to atrial fibrillation and heart failure risk,” says Dr. Tobb.

If you’re hearing about aldosterone’s connection to high blood pressure for the first time, you’re not alone. Dr. Tobb says aldosterone has been underdiagnosed for years despite accounting for an estimated five to 15 percent of high blood pressure cases today. Why? She explains the medical community once believed aldosterone issues only occurred in severe high blood pressure cases and in people with low potassium levels. Experts now know many people can have normal potassium levels and still have high levels of aldosterone.

What causes high aldosterone levels?

Dr. Tobb shares that one common cause of excess aldosterone is a non-cancerous adrenal tumor called an aldosterone-producing adenoma. She says other causes include conditions where the body is trying to compensate for another underlying issue, such as:

• Heart failure
• Severe sleep apnea
• Dehydration
• Liver disease (cirrhosis)
• Taking diuretics or “water pills”

Other lifestyle factors can also raise aldosterone levels, according to Dr. Tobb, including:

• Obesity
• High salt intake
• Chronic stress

What causes low aldosterone levels?

Although less common, aldosterone levels can also become too low, causing symptoms like dizziness, fatigue, dehydration or abnormally high potassium levels, says Dr. Tobb. She explains low aldosterone can be caused by:

• Addison’s disease (adrenal insufficiency)
• Diabetes-related kidney disease
• Medications such as ACE inhibitors, heparin, anti-inflammatory drugs and angiotensin II receptor blockers (ARBs)

Who should get an aldosterone test?

So should you ask your primary care doctor to test your aldosterone levels at your next blood work appointment? It depends. Dr. Tobb says you may benefit from a blood test to check your levels if you:

• Were diagnosed with high blood pressure under age 40
• Live with both hypertension and sleep apnea
• Have a family history of severe high blood pressure or early stroke
• Experience dramatic blood pressure fluctuations
• Have atrial fibrillation along with high blood pressure
• Need three or more medications to control your blood pressure (resistant hypertension)
• Still have high blood pressure despite lifestyle changes
• Have high blood pressure combined with low potassium levels

Dr. Tobb adds that aldosterone testing is covered by insurance in many cases, especially when a person has resistant high blood pressure, low potassium or suspected hormone-related high blood pressure (endocrine hypertension).

If you’re not sure how to start the conversation, she recommends phrasing it something like this: “My blood pressure has been difficult to control. Could we evaluate for hormonal causes like primary aldosteronism?”

3 ways to lower your aldosterone levels

High aldosterone can be treated through surgery to remove an adenoma (if that’s the underlying cause) or medications that block aldosterone called mineralocorticoid receptor antagonists (MRAs). But at home lifestyle changes can also make a huge difference. Here’s what Dr. Tobb recommends:

Lower your salt intake

Swap canned soups, restaurant meals, processed foods like deli meats and salty chips for more whole foods. “Excess sodium can worsen aldosterone-related blood pressure effects and increase fluid retention,” she adds. “Lower sodium intake reduces the hormonal drive and cardiovascular strain.”

Improve sleep and treat sleep apnea

Avoid alcohol before bedtime, stick to a consistent sleep schedule and get evaluated by a professional if you experience daytime fatigue, loud snoring or breathing pauses while sleeping, recommends Dr. Tobb. “Sleep apnea activates stress hormones and the renin-angiotensin-aldosterone system, often increasing aldosterone levels and worsening resistant hypertension,” she adds.

Exercise and maintain a healthy weight

Aim for about 150 minutes of moderate exercise per week (that about 22 minutes per day) along with resistance training, recommends Dr. Tobb. “Visceral fat appears to stimulate hormonal pathways linked to aldosterone production,” she adds. “Weight loss can improve hormonal balance and blood pressure control.”

The bottom line on aldosterone and blood pressure

While some health conditions have a clear explanation, others require a little more digging to figure out what’s going on. If you’re living with stubborn high blood pressure that hasn’t responded to lifestyle changes, don’t lose hope. Asking your doctor about aldosterone could be the missing piece of your health puzzle.

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This story was originally published May 12, 2026 at 5:30 PM.