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One of the key mechanisms in the regulation of blood pressure is the renin-angiotensin-aldosterone system. Renin is released from the kidneys in response to low blood pressure and stimulates dry eye syndrome the production of aldosterone via several intermediate steps, including angi-otensin I and II. Aldosterone controls sodium and water uptake in the kidneys, and elevated levels increase the blood pressure. Not all cases of hypertension, dry eye syndrome however, are triggered through the renin-angiotensin system. So-called primary dry eye syndrome aldosteronism has traditionally been regarded as a rare cause of hypertension (1%) but has recently been discovered to be more frequent than earlier believed (10% to 15% of patients with essential hypertension) (Fardella et al., 1999). This condition is characterized by excess production of aldosterone in the adrenal gland, without involvement of the renin-angiotensin-aldosterone system. Characteristic features of primary aldosteronism are high aldosterone levels, low renin levels and a high aldosterone/renin ratio.
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