Primary aldosteronism: factors associated with normalization of blood pressure after surgery.

Abstract:

BACKGROUND:Hypertension often persists after adrenalectomy for primary aldosteronism. OBJECTIVE:To determine factors associated with resolution of hypertension after adrenalectomy for primary aldosteronism. DESIGN:Retrospective cohort study. SETTING:Tertiary care referral center in Rochester, Minnesota. PATIENTS:All patients who underwent adrenalectomy for primary aldosteronism between 1 January 1993 and 31 December 1999. MEASUREMENTS:Preoperative plasma renin activity, plasma and urinary aldosterone concentrations, and adrenal imaging. Follow-up blood pressure, measured at a clinic visit or at home, was reviewed. RESULTS:97 adrenalectomies were performed, and follow-up was available in 93 patients. Hypertension was resolved at follow-up (blood pressure < 140/90 mm Hg) without use of antihypertensive agents in 31 of 93 patients (33%). According to a stepwise multivariable logistic regression analysis adjusted for duration of follow-up, resolution of hypertension was independently associated with family history of hypertension in no more than 1 first-degree relative (odds ratio [OR], 10.9; P < 0.001) and preoperative use of two or fewer antihypertensive agents (OR, 4.7; P = 0.005). Additional factors associated with resolution of hypertension based on univariate analysis included younger age, shorter duration of hypertension, higher preoperative ratio of plasma aldosterone concentration to plasma renin activity, and higher urine aldosterone level (P < 0.05). CONCLUSIONS:Resolution of hypertension after adrenalectomy for primary aldosteronism is independently associated with a lack of family history of hypertension and preoperative use of two or fewer antihypertensive agents.

journal_name

Ann Intern Med

authors

Sawka AM,Young WF,Thompson GB,Grant CS,Farley DR,Leibson C,van Heerden JA

doi

10.7326/0003-4819-135-4-200108210-00010

subject

Has Abstract

pub_date

2001-08-21 00:00:00

pages

258-61

issue

4

eissn

0003-4819

issn

1539-3704

pii

200108210-00010

journal_volume

135

pub_type

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