Hypertension outcomes of adrenalectomy for unilateral primary
aldosteronism

J 2022

Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism

HARTMANN, Igor, Frantisek HRUSKA, Jan VACLAVIK, Eva KOCIANOVA, Zdenek FRYSAK et. al.

Basic information

Original name

Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism

Authors

HARTMANN, Igor, Frantisek HRUSKA (203 Czech Republic, guarantor), Jan VACLAVIK (203 Czech Republic), Eva KOCIANOVA (203 Czech Republic), Zdenek FRYSAK (203 Czech Republic), Marika NESVADBOVA (203 Czech Republic), Zbynek TUDOS (203 Czech Republic), Filip CTVRTLIK (203 Czech Republic) and Klára BENEŠOVÁ (203 Czech Republic, belonging to the institution)

Edition

ENDOCRINE, NEW YORK, SPRINGER, 2022, 1355-008X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30202 Endocrinology and metabolism

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.700

RIV identification code

RIV/00216224:14110/22:00128270

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s12020-022-02988-y

UT WoS

000754153800002

Keywords in English

Primary aldosteronism; Secondary hypertension; Daily defined dose; Antihypertensive drug treatment; Unilateral adrenalectomy

Abstract

V originále

Purpose To evaluate laboratory and clinical results after unilateral adrenalectomy in patients with primary aldosteronism (PHA). Methods A cross-sectional analysis was performed using data from patients who underwent transperitoneal laparoscopic adrenalectomy for PHA, between January 2008 and December 2019. Surgical indications were based on adrenal venous sampling without ACTH stimulation. Analyses included patient demographics; preoperative clinical, pharmacological, laboratory, and radiological data; and postoperative results assessed after a median of 4 months. Antihypertensive drug use was quantified by estimating the daily defined dose (DDD) of antihypertensive medication, thus enabling standardized comparison of dosage between the drug classes. Statistical assessments included univariable and multivariable logistic regression analysis. Results This study enrolled 87 patients. The patients were taking 5.4 DDD of antihypertensive medication before surgery, and 3.0 DDD after surgery. Complete biochemical success of surgery was reached 67 patients (77%), 19 patients (22%) had partial biochemical success. Complete clinical success with normalization of blood pressure and withdrawal of all antihypertensive drugs was achieved in 19 patients (22%). 57 patients (65%) exhibited a reduction of DDD after surgery and/or improvement of blood pressure-partial clinical success. Thus, in 76 (87%) of all enrolled patients, surgery had an overall positive effect on hypertension control. Multivariable logistic regression showed that complete clinical success was independently associated with female gender and baseline sum of antihypertensive drugs DDD < 4. Conclusion A majority of patients undergoing unilateral adrenalectomy for PHA achieved markedly improved hypertension control, despite almost halving their antihypertensive medication. Almost a quarter of patients were cured and able to cease using all antihypertensive drugs.

Citovat

HARTMANN, Igor, Frantisek HRUSKA, Jan VACLAVIK, Eva KOCIANOVA, Zdenek FRYSAK, Marika NESVADBOVA, Zbynek TUDOS, Filip CTVRTLIK and Klára BENEŠOVÁ. Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism. ENDOCRINE. NEW YORK: SPRINGER, 2022, vol. 76, No 1, p. 142-150. ISSN 1355-008X. Available from: https://dx.doi.org/10.1007/s12020-022-02988-y.

@article{2249608,
   author = {Hartmann, Igor and Hruska, Frantisek and Vaclavik, Jan and Kocianova, Eva and Frysak, Zdenek and Nesvadbova, Marika and Tudos, Zbynek and Ctvrtlik, Filip and Benešová, Klára},
   article_location = {NEW YORK},
   article_number = {1},
   doi = {http://dx.doi.org/10.1007/s12020-022-02988-y},
   keywords = {Primary aldosteronism; Secondary hypertension; Daily defined dose; Antihypertensive drug treatment; Unilateral adrenalectomy},
   language = {eng},
   issn = {1355-008X},
   journal = {ENDOCRINE},
   title = {Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism},
   url = {https://link.springer.com/article/10.1007/s12020-022-02988-y},
   volume = {76},
   year = {2022}
}

TY  - JOUR
ID  - 2249608
AU  - Hartmann, Igor - Hruska, Frantisek - Vaclavik, Jan - Kocianova, Eva - Frysak, Zdenek - Nesvadbova, Marika - Tudos, Zbynek - Ctvrtlik, Filip - Benešová, Klára
PY  - 2022
TI  - Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism
JF  - ENDOCRINE
VL  - 76
IS  - 1
SP  - 142-150
EP  - 142-150
PB  - SPRINGER
SN  - 1355008X
KW  - Primary aldosteronism
KW  - Secondary hypertension
KW  - Daily defined dose
KW  - Antihypertensive drug treatment
KW  - Unilateral adrenalectomy
UR  - https://link.springer.com/article/10.1007/s12020-022-02988-y
N2  - Purpose To evaluate laboratory and clinical results after unilateral adrenalectomy in patients with primary aldosteronism (PHA). Methods A cross-sectional analysis was performed using data from patients who underwent transperitoneal laparoscopic adrenalectomy for PHA, between January 2008 and December 2019. Surgical indications were based on adrenal venous sampling without ACTH stimulation. Analyses included patient demographics; preoperative clinical, pharmacological, laboratory, and radiological data; and postoperative results assessed after a median of 4 months. Antihypertensive drug use was quantified by estimating the daily defined dose (DDD) of antihypertensive medication, thus enabling standardized comparison of dosage between the drug classes. Statistical assessments included univariable and multivariable logistic regression analysis. Results This study enrolled 87 patients. The patients were taking 5.4 DDD of antihypertensive medication before surgery, and 3.0 DDD after surgery. Complete biochemical success of surgery was reached 67 patients (77%), 19 patients (22%) had partial biochemical success. Complete clinical success with normalization of blood pressure and withdrawal of all antihypertensive drugs was achieved in 19 patients (22%). 57 patients (65%) exhibited a reduction of DDD after surgery and/or improvement of blood pressure-partial clinical success. Thus, in 76 (87%) of all enrolled patients, surgery had an overall positive effect on hypertension control. Multivariable logistic regression showed that complete clinical success was independently associated with female gender and baseline sum of antihypertensive drugs DDD < 4. Conclusion A majority of patients undergoing unilateral adrenalectomy for PHA achieved markedly improved hypertension control, despite almost halving their antihypertensive medication. Almost a quarter of patients were cured and able to cease using all antihypertensive drugs.
ER  -

HARTMANN, Igor, Frantisek HRUSKA, Jan VACLAVIK, Eva KOCIANOVA, Zdenek FRYSAK, Marika NESVADBOVA, Zbynek TUDOS, Filip CTVRTLIK and Klára BENEŠOVÁ. Hypertension outcomes of adrenalectomy for unilateral primary aldosteronism. \textit{ENDOCRINE}. NEW YORK: SPRINGER, 2022, vol.~76, No~1, p.~142-150. ISSN~1355-008X. Available from: https://dx.doi.org/10.1007/s12020-022-02988-y.

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