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原发性醛固酮增多症术后持续性高血压的危险因素:一项系统评价和荟萃分析。

Risk factors for persistent hypertension in primary aldosteronism after surgery: a systematic review and meta-analysis.

作者信息

Li Feng, Wan Chao

机构信息

Department of Internal Medicine-Cardiovascular, Xiang'an Branch, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.

出版信息

Front Physiol. 2025 Aug 7;16:1632450. doi: 10.3389/fphys.2025.1632450. eCollection 2025.

Abstract

INTRODUCTION

This systematic review and meta-analysis delved into the identification of risk factors associated with persistent hypertension in patients with primary aldosteronism (PA) following surgery.

METHODS

Through an exhaustive search across PubMed, Embase, and Cochrane Library databases, 12 studies meeting stringent inclusion criteria were scrutinized.

RESULTS

The analysis unveiled several significant risk factors contributing to postoperative hypertension persistence in PA patients. Notably, the duration of hypertension emerged as a pivotal predictor, suggesting a correlation between longer preoperative hypertension durations and heightened postoperative hypertension likelihood. Additionally, elevated body mass index (BMI) surfaced as another notable risk factor, accentuating the imperative of weight management interventions in optimizing surgical outcomes. Further, serum potassium levels and estimated glomerular filtration rate (eGFR) were discerned as crucial determinants of postoperative hypertension. Elevated serum potassium levels and diminished eGFR were associated with an augmented risk of persistent hypertension, underscoring the necessity of meticulous preoperative renal function assessment and electrolyte balance management.

CONCLUSION

These findings underscore the paramount importance of preoperative risk assessment and tailored postoperative management strategies to enhance the prognosis and quality of life for PA patients undergoing surgery.

摘要

引言

本系统评价和荟萃分析深入探讨了原发性醛固酮增多症(PA)患者术后持续性高血压相关危险因素的识别。

方法

通过全面检索PubMed、Embase和Cochrane图书馆数据库,对12项符合严格纳入标准的研究进行了审查。

结果

分析揭示了导致PA患者术后高血压持续存在的几个重要危险因素。值得注意的是,高血压病程成为一个关键预测因素,表明术前高血压病程较长与术后高血压可能性增加之间存在相关性。此外,体重指数(BMI)升高成为另一个显著危险因素,凸显了体重管理干预措施对于优化手术结果的必要性。此外,血清钾水平和估算肾小球滤过率(eGFR)被认为是术后高血压的关键决定因素。血清钾水平升高和eGFR降低与持续性高血压风险增加相关,强调了术前细致的肾功能评估和电解质平衡管理的必要性。

结论

这些发现强调了术前风险评估和针对性术后管理策略对于改善接受手术的PA患者的预后和生活质量的至关重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91aa/12367742/703febe24df3/fphys-16-1632450-g001.jpg

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