Long-term Hypertension Remission in People With Surgically Treated Primary Aldosteronism: A Single-Center Study

Long-term remission rates of hypertension following adrenalectomy for primary aldosteronism (PA) varied across studies. We identified predictors for long-term and sustained hypertension remission among individuals with PA.

Patients who underwent unilateral adrenalectomy for PA at the Prince of Wales Hospital, Hong Kong from January 2000 to October 2022 were reviewed retrospectively. Clinical outcomes were assessed at 2 postsurgical time points: the first follow-up post-surgery and the last follow-up at the time of data retrieval. Complete clinical success is defined as normal blood pressure without the need for anti-hypertensive drugs. Logistic regression was performed to identify parameters and factors associated with complete clinical success at each of the time points and for sustained hypertension remission, defined as complete clinical success at both time points.

Eighty-nine patients were included. Median follow-up duration was 2.1 months and 113.4 months at the first and last post-surgery visit. Complete clinical success was achieved in 61% (N = 54) and 47% (N = 42) at the first and last post-surgery visit. A total of 27.8% (N = 15) of the patients who achieved complete clinical success at the first post-surgery visit did not have sustained hypertension remission. Female sex was associated with greater odds for sustained hypertension remission (odds ratio 4.04, 95% confidence interval 1.38-11.83) while diabetes was associated with reduced likelihood of sustained remission of hypertension (odds ratio 0.13, 95% confidence interval 0.02-0.70).

The prevalence of hypertension remission after adrenalectomy is 47% over a median follow-up of 9 years. Diabetes was associated with a lower odds of sustained hypertension remission.