Document Detail


Primary aldosteronism: factors associated with normalization of blood pressure after surgery.
MedLine Citation:
PMID:  11511140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypertension often persists after adrenalectomy for primary aldosteronism. OBJECTIVE: To determine factors associated with resolution of hypertension after adrenalectomy for primary aldosteronism. DESIGN: Retrospective cohort study. SETTING: Tertiary care referral center in Rochester, Minnesota. PATIENTS: All patients who underwent adrenalectomy for primary aldosteronism between 1 January 1993 and 31 December 1999. MEASUREMENTS: Preoperative plasma renin activity, plasma and urinary aldosterone concentrations, and adrenal imaging. Follow-up blood pressure, measured at a clinic visit or at home, was reviewed. RESULTS: 97 adrenalectomies were performed, and follow-up was available in 93 patients. Hypertension was resolved at follow-up (blood pressure < 140/90 mm Hg) without use of antihypertensive agents in 31 of 93 patients (33%). According to a stepwise multivariable logistic regression analysis adjusted for duration of follow-up, resolution of hypertension was independently associated with family history of hypertension in no more than 1 first-degree relative (odds ratio [OR], 10.9; P < 0.001) and preoperative use of two or fewer antihypertensive agents (OR, 4.7; P = 0.005). Additional factors associated with resolution of hypertension based on univariate analysis included younger age, shorter duration of hypertension, higher preoperative ratio of plasma aldosterone concentration to plasma renin activity, and higher urine aldosterone level (P < 0.05). CONCLUSIONS: Resolution of hypertension after adrenalectomy for primary aldosteronism is independently associated with a lack of family history of hypertension and preoperative use of two or fewer antihypertensive agents.
Authors:
A M Sawka; W F Young; G B Thompson; C S Grant; D R Farley; C Leibson; J A van Heerden
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  135     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-20     Completed Date:  2001-09-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  258-61     Citation Subset:  AIM; IM    
Affiliation:
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / complications,  surgery
Adrenal Gland Neoplasms / complications,  surgery
Adrenalectomy
Adult
Aged
Aged, 80 and over
Aldosterone / analysis
Analysis of Variance
Antihypertensive Agents / therapeutic use
Cohort Studies
Female
Humans
Hyperaldosteronism / complications,  surgery*
Hypertension* / drug therapy,  etiology,  genetics
Logistic Models
Male
Middle Aged
Renin / blood
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 52-39-1/Aldosterone; EC 3.4.23.15/Renin
Comments/Corrections
Comment In:
Ann Intern Med. 2003 Jan 21;138(2):157-9; author reply 157-9   [PMID:  12529104 ]

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


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