Document Detail


Long-term blood pressure control in patients undergoing adrenalectomy for primary hyperaldosteronism.
MedLine Citation:
PMID:  25456918     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Data on long-term blood pressure (BP) control after adrenalectomy for primary hyperaldosteronism are limited. We analyzed long-term outcomes to identify factors predictive of cure.
METHODS: We performed a retrospective cohort study of patients undergoing adrenalectomy for primary hyperaldosteronism (1997-2013). BP and antihypertensive medications were assessed at long-term follow-up (≥12 months). Primary outcome was cure, defined as normotension off antihypertensives.
RESULTS: Of 85 patients, 15.3% (n = 13) were cured, 54.1% (n = 46) were normotensive while remaining on anti-hypertensives, and 30.6% (n = 26) were hypertensive. Younger age (P = .011), female sex (P < .001), lesser body mass index (P = .018), shorter duration of hypertension (P = .002), lower creatinine (P = .001), and fewer preoperative antihypertensive medications (P < .001) were associated with cure. Female sex, body mass index ≤25 kg/m(2), hypertension <5 years, creatinine ≤0.8 mg/dL, and <2 antihypertensives were incorporated into a scoring system. For a score of 0-1 (n = 61) the cure rate was 3%; 100% of patients with a score of 4-5 (n = 3) were cured. This scoring system performed comparably to the Aldosterone Resolution Score, which has been used to evaluate short-term postoperative outcomes.
CONCLUSION: This is the largest study to identify factors associated with long-term BP control after adrenalectomy and incorporate these into a scoring system. These data provide a potential tool to guide preoperative patient counseling.
Authors:
Heather Wachtel; Isadora Cerullo; Edmund K Bartlett; Rachel R Kelz; Debbie L Cohen; Giorgos C Karakousis; Robert E Roses; Douglas L Fraker
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Publication Detail:
Type:  Journal Article     Date:  2014-11-11
Journal Detail:
Title:  Surgery     Volume:  156     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1394-403     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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