| Primary aldosteronism: factors associated with normalization of blood pressure after surgery. | |
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MedLine Citation:
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PMID: 11511140 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A M Sawka; W F Young; G B Thompson; C S Grant; D R Farley; C Leibson; J A van Heerden |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of internal medicine Volume: 135 ISSN: 0003-4819 ISO Abbreviation: Ann. Intern. Med. Publication Date: 2001 Aug |
Date Detail:
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Created Date: 2001-08-20 Completed Date: 2001-09-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 258-61 Citation Subset: AIM; IM |
Affiliation:
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Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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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:
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0/Antihypertensive Agents; 52-39-1/Aldosterone; EC 3.4.23.15/Renin |
| Comments/Corrections | |
Comment In:
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Ann Intern Med. 2003 Jan 21;138(2):157-9; author reply 157-9
[PMID:
12529104
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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