Primary aldosteronism: Factors associated with normalization of blood pressure after surgery

A. M. Sawka, Jr Young, G. B. Thompson, C. S. Grant, D. R. Farley, C. Leibson, J. A. Van Heerden

Research output: Contribution to journalArticle

247 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)258-261
Number of pages4
JournalAnnals of internal medicine
Volume135
Issue number4
DOIs
StatePublished - Aug 21 2001

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint Dive into the research topics of 'Primary aldosteronism: Factors associated with normalization of blood pressure after surgery'. Together they form a unique fingerprint.

  • Cite this