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Predictors of resolution of hypertension after adrenalectomy in patients with aldosterone-producing adenoma.

Authors
Kim, RM; Lee, J; Soh, EY
Citation
Journal of Korean medical science, 25(7):1041-1044, 2010
Journal Title
Journal of Korean medical science
ISSN
1011-89341598-6357
Abstract
Primary aldosteronism (PA) is a frequent cause of secondary hypertension and is amenable to surgical intervention when it is caused by aldosterone-producing adenoma (APA). Many patients, however, continue to require antihypertensive medications to control their blood pressure after adrenalectomy. The aim of this study was to determine the preoperative factors that predict clinical outcomes after adrenalectomy in patients with APA. We studied 27 patients (mean age 45+/-4 yr) who had APA and underwent unilateral adrenalectomy between December 1995 and September 2008 at our institution. Clinical and biochemical data were evaluated at baseline and after a mean follow-up of 51.8+/-47.0 months (range, 6-159). At the end of the follow-up, 16 patients (59.3%) were considered to experience "complete resolution" without postoperative medications, whereas 7 patients (25.9%) "improved" with medications and 4 patients (14.8%) were "uncontrolled." Three factors (< or =2 antihypertensive medications [P=0.007], duration of hypertension <6 yr [P=0.002], and serum aldosterone <350 pg/mL [P<0.001]) were the predictive for complete resolution in univariate analysis. Multivariate regression analysis showed that serum aldosterone level (<350 pg/mL) was the single most important factor that predicted complete resolution after surgery (P<0.001). The best preoperative clinical factor that predicted resolution of postoperative hypertension after adrenalectomy is serum aldosterone level (<350 pg/mL).
MeSH terms
Adrenalectomy*Adrenocortical Adenoma*/complicationsAdrenocortical Adenoma*/surgeryAdultAldosterone/blood*FemaleHumansHyperaldosteronism*/complicationsHyperaldosteronism*/surgeryHypertension*/etiologyHypertension*/surgeryMaleMiddle AgedRetrospective StudiesTreatment Outcome
DOI
10.3346/jkms.2010.25.7.1041
PMID
20592896
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
김, 라미이, 잔디소, 의영
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