Long-term Blood Pressure Outcome After Unilateral Adrenalectomy for Primary Hyperaldosteronism
Condition: Adrenalectomy; Status
MeSH terms: Hyperaldosteronism
Study type: Observational

Summary: 
      To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify
      prognostic factors associated.

      Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA
      between 2002 and 2013 in our department. All patients underwent preoperative: clinical
      evaluation (age, sex, height, weight, systolic and diastolic BP under treatment,
      identification of anti-hypertension treatment), biological evaluation (potassium, renin,
      aldosterone) and radiological evaluation (CT and/or MRI). Blood pressure was assessed
      postoperatively at 1 month, 1 year, then at the date of the latest news. The patients were
      classified into three categories: cured (no antihypertensive therapy in postoperative
      associated with strictly lower blood pressures of 140/90mmHg), improved (decreased number of
      drugs or number unchanged but with better blood pressure control), and refractory (no change
      in the number of drug and blood pressure, or deterioration of one or other of these two
      parameters).
    

Detailed description: 
      To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify
      prognostic factors associated.Exhaustive retrospective review of all consecutive patients
      undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients
      underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic
      BP under treatment, identification of anti-hypertension treatment), biological evaluation
      (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI). Blood pressure
      was assessed postoperatively at 1 month, 1 year, then at the date of the latest news. The
      patients were classified into three categories: cured (no antihypertensive therapy in
      postoperative associated with strictly lower blood pressures of 140/90mmHg), improved
      (decreased number of drugs or number unchanged but with better blood pressure control), and
      refractory (no change in the number of drug and blood pressure, or deterioration of one or
      other of these two parameters).
    

Intervention name(s): adrenalectomy for primary addosteronism
Intervention type(s): Other
Intervention description(s): All of the clinical and biological data were retrospectively compiled from the patient computerized record. The variables analyzed were: age, sex, body mass index (BMI), PAH discovery circumstances, pre- and postoperative systolic and diastolic blood pressure assessments, number of pre-hypertensive antihypertensive drug - and postoperatively, the laterality, the size and nature of the lesions, the operating time, the surgical technique used. The biological data evaluated were pre- and postoperative plasma and plasma creatinine, preoperative serum aldosterone concentrations, plasma renin activity, and preoperative aldosterone / renin ratio. Hypokalemia was defined as serum concentration below 3.5 mmol / L.
Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Between 2002 and 2013, the investigators evaluated all patients receiving adrenalectomy and
        extracted data on PAH patients. The diagnosis was made on the presence of hypertension (all
        stages combined), an autonomous hyperproduction of aldosterone and sometimes hypokalemia (n
        = 32). HTA was defined, in accordance with the recommendations of the Haute Autorité de
        Santé and the French Society of Arterial Hypertension (blood pressure greater than or equal
        to 140/90 mmHg)
      
Keywords: blood pressure