Unexpected incidence of low blood pressure 2 years after unilateral adrenalectomy for primary aldosteronism.

Abstract:

:1. Serial observations of blood pressure after unilateral adrenalectomy for aldosterone-producing adenoma revealed an incidence of hypotension (systolic BP less than fifth percentile for age- and sex-matched normal population) of 27% at 2 years, more than 5 times that predicted. 2. Serial observations of volume regulatory hormones showed significantly raised mean levels of plasma renin activity consistent with hypovolaemia. Significantly reduced mean aldosterone levels despite significantly raised mean plasma renin activity levels may reflect reduced responsiveness of the remaining adrenal. 3. Reduction of significantly elevated preoperative ANP levels to significantly reduced levels postoperatively is also in keeping with postoperative hypovolaemia. 4. A 50% reduction in plasma adrenaline after unilateral adrenalectomy might contribute to reduced noradrenergic activity (prejunctional beta-receptor) and reduced blood pressure, but plasma noradrenaline did not fall significantly postoperatively. 5. Postoperative levels of renin, aldosterone, adrenaline and noradrenaline were not significantly different between those who did, and those who did not, become hypotensive.

authors

Gordon RD,Hawkins PG,Hamlet SM,Tunny TJ,Klemm SA,Backmann AW,Finn WL

doi

10.1111/j.1440-1681.1989.tb01558.x

subject

Has Abstract

pub_date

1989-04-01 00:00:00

pages

281-6

issue

4

eissn

0305-1870

issn

1440-1681

journal_volume

16

pub_type

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