Document Detail


Essential hypertension: first reason for persistent hypertension after unilateral adrenalectomy for primary aldosteronism?
MedLine Citation:
PMID:  9854594     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite cure of primary aldosteronism by surgical resection, hypertension persists postoperatively in 30% to 50% of patients. The aim of this study was to determine factors influencing long-term outcome of blood pressure after unilateral adrenalectomy for primary aldosteronism. METHODS: Records of 100 patients who underwent unilateral adrenalectomy for primary aldosteronism from 1970 through 1997 were reviewed. Patients were distributed in 2 groups according to whether blood pressure was normal (criteria of World Health Organization). Clinical, biochemical, and pathologic data were compared. RESULTS: All patients were biochemically cured. Blood pressure was normal in 56 patients and improved in 44 (mean follow-up, 69 and 59 months). Persistent hypertension correlated with age, known duration and seriousness of preoperative hypertension, family history of hypertension, no preoperative response to spironolactone, and contralateral adrenal hypertrophy. Gender, surgical approach, and pathologic findings were not predictive factors of blood pressure outcome. The prevalence of hypertension was almost the same in these postoperative patients as the prevalence of essential hypertension in a random population of the same age. CONCLUSIONS: Early unilateral adrenalectomy allows cure or improvement of hypertension in all patients with primary aldosteronism induced by unilateral excessive source of aldosterone secretion regardless of the pathologic findings. Persistent hypertension suggests that coexisting essential hypertension is present.
Authors:
C A Proye; E A Mulliez; B M Carnaille; M Lecomte-Houcke; M Decoulx; J L Wémeau; J Lefebvre; A Racadot; O Ernst; D Huglo; A Carré
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  124     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-11     Completed Date:  1999-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1128-33     Citation Subset:  AIM; IM    
Affiliation:
Department of General and Endocrine Surgery, Lille University Hospital, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenalectomy*
Adult
Aged
Female
Follow-Up Studies
Humans
Hyperaldosteronism / complications,  surgery*
Hypertension / epidemiology,  etiology,  surgery*
Male
Middle Aged

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


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