Langenbeck's archives of surgery · 2007
Rare normalization of blood pressure after unilateral adrenalectomy in 31 patients with Conn syndrome.
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Ziaja Jacek, Chudek Jerzy, Król Robert, Pawlicki Jacek, Wiecek Andrzej, Cierpka Lech
Аннотация
BACKGROUND: Adrenal tumor excision in patients with Conn syndrome is not always followed by normalization of blood pressure (BP). The aim of the study was to determine predictors of persistent hypertension during long-term observation after adrenalectomy.
MATERIALS AND METHODS: Thirty-one patients (23 F and 8 M) with Conn syndrome and adrenal tumor subjected to unilateral adrenalectomy were included. The duration of hypertension ranged from 1 to 30 years and observation time from 1 to 10 years.
RESULTS: Beneficial impact of adrenalectomy on BP control was found in 25 patients, including only 10 patients with BP normalization. Patients with normalization of BP were significantly younger [41 (36-46) vs 53 (48-57) years; p = 0.002] and had lower pulse BP [72 (56-89) vs 93(80-106) mmHg; p = 0.03]. Significant decline of maximal values of systolic and diastolic BP after surgery was observed [59 (47-72) and 29 (20-37) mmHg, respectively]. The analysis revealed that age over 50 years and pulse BP over 70 mmHg predict the persistence of hypertension after surgery.
CONCLUSION: Normalization of BP after adrenalectomy is observed only in 32% of patients with Conn syndrome regardless the normalization of hypokalemia. BP normalization in long period observation was more frequently found in younger patients with lower pulse BP.
MATERIALS AND METHODS: Thirty-one patients (23 F and 8 M) with Conn syndrome and adrenal tumor subjected to unilateral adrenalectomy were included. The duration of hypertension ranged from 1 to 30 years and observation time from 1 to 10 years.
RESULTS: Beneficial impact of adrenalectomy on BP control was found in 25 patients, including only 10 patients with BP normalization. Patients with normalization of BP were significantly younger [41 (36-46) vs 53 (48-57) years; p = 0.002] and had lower pulse BP [72 (56-89) vs 93(80-106) mmHg; p = 0.03]. Significant decline of maximal values of systolic and diastolic BP after surgery was observed [59 (47-72) and 29 (20-37) mmHg, respectively]. The analysis revealed that age over 50 years and pulse BP over 70 mmHg predict the persistence of hypertension after surgery.
CONCLUSION: Normalization of BP after adrenalectomy is observed only in 32% of patients with Conn syndrome regardless the normalization of hypokalemia. BP normalization in long period observation was more frequently found in younger patients with lower pulse BP.