Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.
Department of Mathematical Sciences G. L. Lagrange, Polytechnic University of Torino, Torino, Italy.
Eur J Clin Invest. 2021 Mar;51(3):e13419. doi: 10.1111/eci.13419. Epub 2020 Oct 14.
Previous studies suggested that patients affected by primary aldosteronism (PA) have impaired quality of life (QOL) compared to the general population, but a direct comparison with patients affected by essential hypertension (EH) has never been performed. The aim of the study was to compare the QOL of patients affected by PA to the QOL of patients affected by EH.
We designed a prospective observational study comparing the QOL of patients with PA and carefully matched patients with EH before and after treatment. We recruited 70 patients with PA and 70 patients with EH, matched for age, sex, blood pressure levels and intensity of antihypertensive treatment. We assessed QOL at baseline and after specific treatment for PA or after optimization of medical therapy for patients with EH.
Patients with PA displayed impaired QOL compared with the general healthy population, but similar to patients with EH. Both laparoscopic adrenalectomy and treatment with mineralocorticoid receptor antagonist allowed an improvement of QOL in patients with PA, that was more pronounced after surgical treatment. Optimization of blood pressure control by implementation of antihypertensive treatment (without MR antagonists) allowed a minimal improvement in only one of eight domains in patients with EH.
Patients with PA have impaired QOL, which is likely caused by uncontrolled hypertension and the effects of intensive antihypertensive treatment. Surgical and medical treatment of PA allows a significant improvement of QOL, by amelioration of blood pressure control and, after surgical treatment, by reduction of antihypertensive treatment.
先前的研究表明，与普通人群相比，原发性醛固酮增多症（PA）患者的生活质量（QOL）受损，但从未与原发性高血压（EH）患者进行过直接比较。本研究旨在比较 PA 患者与 EH 患者的 QOL。
我们设计了一项前瞻性观察性研究，比较了 PA 患者和经过治疗的 EH 患者的 QOL。我们招募了 70 名 PA 患者和 70 名 EH 患者，按照年龄、性别、血压水平和降压治疗强度进行匹配。我们在基线时评估了 QOL，并在 PA 进行特定治疗或 EH 进行优化药物治疗后进行了评估。
与一般健康人群相比，PA 患者的 QOL 受损，但与 EH 患者相似。腹腔镜肾上腺切除术和使用盐皮质激素受体拮抗剂治疗均可改善 PA 患者的 QOL，手术治疗后改善更为明显。通过实施降压治疗（不使用 MR 拮抗剂）优化血压控制仅使 EH 患者的八个领域中的一个得到最小改善。
PA 患者的 QOL 受损，这可能是由未控制的高血压和强化降压治疗的影响引起的。PA 的手术和药物治疗可通过改善血压控制以及手术后减少降压治疗来显著改善 QOL。
