J Endocr Surg.  2021 Dec;21(4):86-93. 10.16956/jes.2021.21.4.86.

Effectiveness of Unilateral Adrenalectomy in Primary Hyperaldosteronism on Blood Pressure Regulation

• Jeong SY
• Sul JY
• Park J

• KMID: 2525971
• DOI: http://doi.org/10.16956/jes.2021.21.4.86

Abstract

Purpose
The study was designed to determine the long-term outcome of the blood pressure after surgical treatment in primary hyperaldosteronism.
Methods
The medical records of patients with unilateral primary hyperaldosteronism who had undergone laparoscopic adrenalectomy were retrospectively reviewed from January 2001 to December 2020 in a single center. Patient demographics, postoperative blood pressure changes and related factors of clinical success in patients with primary hyperaldosteronism were analyzed.
Results
Of 63 patients enrolled and analyzed, 32 (51%) achieved complete clinical success, 31 (49%) achieved partial clinical success, and 0 (0%) had no clear success. However, within the partial clinical success group, the mean±standard deviation systolic and diastolic BP decreased significantly by 23.3±28.5 mmHg (P<0.01) and 6.5±18.9 mmHg (P=0.06), respectively. Also, the number of antihypertensive medications used decreased from 6 (range, 3–16) to 2 (range, 0.5–6.5) (P<0.01). In univariate analysis, being male (P<0.01), the number of preoperative anti-hypertensive drugs administered (P<0.01), and the preoperative systolic blood pressure (P=0.01) were the main factors related to partial clinical success after adrenalectomy. In multivariate regression analysis, uncured hypertension was independently associated with the number of preoperative antihypertensive agents (P=0.04) Conclusion: Although hypertension cannot be cured in all patients, unilateral adrenalectomy performed for localized primary hyperaldosteronism is effective in improving hypertension in patients with primary hyperaldosteronism.

Keyword

Primary hyperaldosteronism; Adrenalectomy; Hypertension