Factors Affecting Complete Hypertension Cure after Adrenalectomy for Aldosterone-Producing Adenoma: Outcomes in a Large Series

Objective: The purpose of this study was to evaluate the impact of hypokalemia on hypertension outcomes in patients with aldosterone-producing adenoma (APA) after adrenalectomy and to determine the factors affecting complete hypertension cure in a large series. Methods: Characteristics from 376 APA patients treated with adrenalectomy between 2005 and 2011 were collected from our center. Factors affecting complete hypertension cure were assessed using logistic regression. Results: At the end of follow-up, 207 (55.05%) patients were completely cured, whereas 138 (36.7%) patients were improved, and 31 (8.3%) patients remain refractory. Age (p = 0.028), > 2 antihypertensive agents (p < 0.001), duration of hypertension (p < 0.001), duration of hypokalemia (p = 0.037), systolic blood pressure (p = 0.016), and level of plasma aldosterone (p < 0.001) were associated with hypertension outcomes in univariate analysis. However, multivariate logistic regression analysis showed that only duration of hypertension = 6 years (OR = 0.496, 95% CI 0.3230.762, p = 0.001) and level of plasma aldosterone = 35 ng/dl (OR = 0.503, 95% CI 0.326-0.776, p = 0.002) were the significantly independent factors affecting complete hypertension cure. Conclusions: This is the largest series to show that only duration of hypertension and level of plasma aldosterone were the factors affecting complete hypertension cure after adrenalectomy for APA. This study highlights the importance of early diagnosis and early adrenalectomy. Copyright (C) 2013 S. Karger AG, Basel