Document Detail


Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma.
MedLine Citation:
PMID:  18698217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess blood pressure outcome in patients with primary aldosteronism, who were operated on the basis of a unilateral adenoma detected by computed tomography or a lateralized aldosterone hypersecretion detected by adrenal venous sampling, and to analyze the hormonal and nonhormonal factors associated with the outcome. METHODS: A retrospective study of 168 patients with primary aldosteronism undergoing surgery: 109 patients with a unilateral adenoma detected by computed tomography and 59 without a unilateral adenoma who underwent surgery because of an aldosterone to cortisol ratio at least five times higher on the dominant side than on the nondominant side. RESULTS: Patients with a unilateral adenoma were more likely to be women, had a shorter history of hypertension and had lower blood pressure levels and treatment scores than patients without a unilateral adenoma. The mean systolic blood pressures of patients with and without unilateral adenomas at follow-up were 133 +/- 16 and 137 +/- 16 mmHg, respectively. Hypertension cure or improvement was observed in 77% (95% confidence interval 69-85%) and 68% (95% confidence interval 56-80%) of patients, respectively. Using a linear regression model, baseline urinary aldosterone was positively associated, and baseline serum potassium was negatively associated, with decrease in systolic blood pressure. CONCLUSION: Adrenalectomy improves blood pressure control in patients with primary aldosteronism operated on the basis of either unilateral adenoma detected by computed tomography or a lateralized aldosterone hypersecretion. A high urinary aldosterone excretion and a low serum potassium level predict a more favorable outcome of surgery.
Authors:
Emmanuel Letavernier; Séverine Peyrard; Laurence Amar; Franck Zinzindohoué; Béatrice Fiquet; Pierre-François Plouin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  26     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-13     Completed Date:  2008-12-19     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1816-23     Citation Subset:  IM    
Affiliation:
AP-HP, Hôpital Européen Georges Pompidou, Hypertension unit, Faculté de Médecine, Université Paris Descartes, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  surgery*
Adrenal Gland Neoplasms / complications,  surgery*
Adrenalectomy*
Adult
Aldosterone / urine
Blood Pressure
Female
Follow-Up Studies
Humans
Hyperaldosteronism / etiology,  surgery*
Hypertension / diagnosis,  etiology*
Linear Models
Male
Middle Aged
Multivariate Analysis
Potassium / blood
Predictive Value of Tests
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
52-39-1/Aldosterone; 7440-09-7/Potassium
Comments/Corrections
Comment In:
J Hypertens. 2009 Mar;27(3):656-7; author reply 657-8   [PMID:  19262233 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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