Prognostic Predictors of Hypertension Outcomes After Adrenalectomy in Primary Aldosteronism.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL In vivo Pub Date : 2024-11-01 DOI:10.21873/invivo.13751

Hajime Fukushima, Kensuke Mitsunari, Junki Harada, Yuichiro Nakamura, Tomohiro Matsuo, Kojiro Ohba, Yasushi Mochizuki, Ryoichi Imamura

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Abstract

Background/aim: Hypertension does not always improve after adrenalectomy for primary aldosteronism (PA), and antihypertensive medications cannot always be discontinued. This study aimed to identify the prognostic predictors of hypertension following adrenalectomy for PA.

Patients and methods: This retrospective cohort study included patients undergoing adrenalectomy for PA between 2008 and 2022 at a tertiary hospital, grouping them based on whether they had normal blood pressure without antihypertensive medications or still required medications postoperatively. Age, sex, body mass index (BMI), biochemical data, hypertension duration, pre- and post-operative defined daily dose (DDD) of antihypertensive drugs, presence of metabolic syndrome (MetS)-related diseases, and visceral fat area and volume (recorded using preoperative abdominal computed tomography) were the outcome measures.

Results: A total of 71 (clinical success, n=21) (nonclinical success, n=50) patients were included. A high BMI (p=0.038), DDD (p=0.008), and visceral fat volume (p=0.048); long hypertension duration (p=0.034); and the presence of MetS-related diseases (p=0.014) were associated with a low clinical success rate on univariate analyses. After adjusting for age and sex, hypertension duration (p=0.047), MetS-related diseases (p=0.021), and DDD (p=0.011) were potential prognostic predictors.

Conclusion: Hypertension duration, MetS-related diseases, and DDD are potential prognostic predictors of hypertension following surgery for PA.

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原发性醛固酮增多症肾上腺切除术后高血压预后的预测因素

背景/目的：原发性醛固酮增多症（PA）肾上腺切除术后，高血压并不总能得到改善，而且降压药物也不一定能停用。本研究旨在确定肾上腺切除术治疗 PA 后高血压的预后预测因素：这项回顾性队列研究纳入了2008年至2022年间在一家三级医院接受肾上腺切除术治疗PA的患者，根据他们的血压是否正常、未服用降压药或术后仍需服药进行分组。结果以年龄、性别、体重指数（BMI）、生化数据、高血压持续时间、术前和术后降压药物的规定日剂量（DDD）、是否患有代谢综合征（MetS）相关疾病以及内脏脂肪面积和体积（术前使用腹部计算机断层扫描记录）为衡量指标：共纳入 71 名患者（临床成功，21 人）（非临床成功，50 人）。在单变量分析中，高体重指数（P=0.038）、高密度脂蛋白（P=0.008）和内脏脂肪体积（P=0.048）、高血压持续时间长（P=0.034）以及存在 MetS 相关疾病（P=0.014）与临床成功率低有关。调整年龄和性别后，高血压持续时间（p=0.047）、MetS相关疾病（p=0.021）和DDD（p=0.011）是潜在的预后预测因素：结论：高血压持续时间、MetS相关疾病和DDD是PA手术后高血压的潜在预后预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.