Risk factors associated with persistent postoperative hypertension in Cushing's syndrome

Area of Science:

• Endocrinology
• Surgical Oncology
• Cardiovascular Medicine

Background:

• Cushing's syndrome, caused by cortisol-producing adrenocortical adenomas, frequently leads to hypertension.
• Adrenalectomy is the primary treatment, but long-term blood pressure (BP) control post-surgery requires further investigation.

Purpose of the Study:

• To evaluate the long-term results of adrenalectomy in Cushing's syndrome patients.
• To identify risk factors associated with persistent or recurrent hypertension after surgical cure.

Main Methods:

• Retrospective analysis of 45 patients with Cushing's syndrome due to benign adrenocortical adenomas.
• Preoperative and 1-year postoperative BP monitoring, categorized by preoperative BP levels (<140/90 mmHg vs. ≥140/90 mmHg).

Main Results:

• Patients with higher preoperative BP (≥140/90 mmHg) exhibited persistently higher BP levels post-adrenalectomy compared to those with normal preoperative BP.
• Postoperative BP correlated significantly with the duration of preoperative hypertension (P<0.05).
• No significant correlation was found between postoperative BP and age, BMI, tumor size, or specific hormone/metabolite levels.

Conclusions:

• Preoperative BP level is a critical determinant of persistent hypertension following adrenalectomy for Cushing's syndrome.
• Intensive preoperative BP management to maintain levels below 140/90 mmHg is crucial for improving postoperative BP prognosis.
• Prompt diagnosis and surgical intervention to minimize hypertension duration are vital for long-term BP outcomes.