Endocrinol Metab.  2018 Sep;33(3):355-363. 10.3803/EnM.2018.33.3.355.

Factors Associated with Resolution of Hypertension after Adrenalectomy in Patients with Primary Aldosteronism

• Loh WJ
• Lim DS
• Loh LM
• Kek PC

• KMID: 2447025
• DOI: http://doi.org/10.3803/EnM.2018.33.3.355

Abstract

BACKGROUND
The aim of this study was to investigate the factors associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism. A secondary aim was to describe our use of the contralateral ratio in adrenal venous sampling (AVS) in the setting of suboptimal successful cannulation rates.
METHODS
A retrospective review of patients who underwent AVS followed by unilateral adrenalectomy for primary aldosteronism was performed.
RESULTS
Complete resolution of hypertension and hypokalemia was seen in 17 of 40 patients (42.5%), while a clinical improvement in hypertension was seen in 38 of 40 (95%). Shorter duration of hypertension, mean aldosteronoma resolution score (ARS), and a high ARS of 3 to 5 were associated with resolution of hypertension after adrenalectomy (P=0.02, P=0.02, and P=0.004, respectively). Of the individual components of ARS, only a duration of hypertension of ≤6 years was associated with resolution of hypertension after adrenalectomy (P=0.03).
CONCLUSION
A shorter duration of hypertension was significantly associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism.

Keyword

Contralateral ratio; Adrenal venous sampling; Primary aldosteronism

MeSH Terms

Adrenalectomy*
Catheterization
Humans
Hyperaldosteronism*
Hypertension*
Hypokalemia
Retrospective Studies

Figure

• 

  Fig. 1 Details of 81 patients who underwent adrenal venous sampling followed by surgery. ACTH, adrenocorticotropic hormone; AVS, adrenal venous sampling; LR, lateralization ratio; CR, contralateral ratio.

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