Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
In Vivo. 2024 Nov-Dec;38(6):2729-2734. doi: 10.21873/invivo.13751.
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.
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.
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.
Hypertension duration, MetS-related diseases, and DDD are potential prognostic predictors of hypertension following surgery for PA.
背景/目的：原发性醛固酮增多症（PA）患者行肾上腺切除术治疗后，高血压并不总是能得到改善，且降压药物也不能总是停用。本研究旨在确定 PA 患者行肾上腺切除术治疗后高血压的预后预测因子。
这是一项回顾性队列研究，纳入了 2008 年至 2022 年期间在一家三级医院接受肾上腺切除术治疗的 PA 患者，根据术后血压正常且无需服用降压药物或仍需服用降压药物将其分组。年龄、性别、体重指数（BMI）、生化数据、高血压持续时间、术前和术后的降压药物日剂量（DDD）、代谢综合征（MetS）相关疾病的存在情况、以及内脏脂肪面积和体积（使用术前腹部计算机断层扫描记录）是本研究的观察指标。
共纳入 71 例（临床成功 21 例，非临床成功 50 例）患者。单因素分析显示，高 BMI（p=0.038）、DDD（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）与临床成功率较低相关。在校正年龄和性别后，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子。
高血压持续时间、MetS 相关疾病和 DDD 是 PA 患者术后高血压的潜在预后预测因子。
