In primary hyperaldosteronism, which statement best describes fluid status?

• A. They are volume expanded but not edematous
• B. They have significant edema
• C. They are hypovolemic
• D. They have hypoalbuminemia causing edema

Answer: (A)

Primary hyperaldosteronism drives sodium and water retention, which expands the extracellular fluid volume and raises blood pressure. At the same time, edema is not a typical feature because the expanded intravascular volume does not usually translate into interstitial fluid accumulation; mechanisms like aldosterone escape help prevent edema and maintain a relatively euvolemic state outside of mild volume expansion. So the fluid status is best described as volume expanded but not edematous. Edema would point more toward hypoalbuminemia, liver/kidney failure, or heart failure, where interstitial fluid accumulation occurs. Hypovolemia is unlikely because sodium retention is the hallmark.