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

Abstract

BackgroundThe 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.MethodsA retrospective review of patients who underwent AVS followed by unilateral adrenalectomy for primary aldosteronism was performed.ResultsComplete 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).ConclusionA shorter duration of hypertension was significantly associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism.

Keywords

• Contralateral ratio
• Adrenal venous sampling
• Primary aldosteronism