Risk factors associated with postoperative persistent hypertension in patients with primary aldosteronism

Area of Science:

• Endocrinology
• Surgical Oncology
• Hypertension Research

Background:

• Primary aldosteronism is a condition leading to excess aldosterone production.
• Unilateral adrenalectomy is a common treatment for primary aldosteronism.
• While effective in resolving hyperaldosteronism, persistent hypertension remains a challenge in 38% of patients post-surgery.

Purpose of the Study:

• To identify key factors predicting persistent hypertension after unilateral adrenalectomy for primary aldosteronism.
• To guide clinical decision-making and patient counseling regarding surgical outcomes.

Main Methods:

• A retrospective analysis of 63 patients who underwent unilateral adrenalectomy.
• Stepwise multivariate logistic regression was employed to evaluate clinicopathologic predictors of persistent hypertension.

Main Results:

• Age (≥50 years), male sex, and specific pathological findings (multiple adenomas or adenoma with macronodules) were significant predictors of persistent hypertension.
• Older patients (≥50) had a 10.6-fold increased odds of persistent hypertension compared to younger patients (<40).
• Male patients (OR 5.9) and those with specific adenoma types (OR 8.1) also showed significantly higher odds of persistent hypertension.

Conclusions:

• Early surgical intervention in younger patients with primary aldosteronism is associated with better long-term outcomes.
• The presence of macronodules alongside an adenoma serves as a crucial indicator for potential persistent hypertension post-adrenalectomy.