| Blood pressure outcome of adrenalectomy in patients with primary hyperaldosteronism with or without unilateral adenoma. | |
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MedLine Citation:
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PMID: 18698217 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Emmanuel Letavernier; Séverine Peyrard; Laurence Amar; Franck Zinzindohoué; Béatrice Fiquet; Pierre-François Plouin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of hypertension Volume: 26 ISSN: 0263-6352 ISO Abbreviation: J. Hypertens. Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-13 Completed Date: 2008-12-19 Revised Date: 2009-04-16 |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 1816-23 Citation Subset: IM |
Affiliation:
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AP-HP, Hôpital Européen Georges Pompidou, Hypertension unit, Faculté de Médecine, Université Paris Descartes, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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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:
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52-39-1/Aldosterone; 7440-09-7/Potassium |
| Comments/Corrections | |
Comment In:
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J Hypertens. 2009 Mar;27(3):656-7; author reply 657-8
[PMID:
19262233
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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