42 THE DEFINED DAILY DOSE CAN ASSESS POSTOPERATIVE CHANGE IN ANTIHYPERTENSIVE DRUG CONSUMPTION IN PATIENTS WITH PRIMARY ALDOSTERONISM

Abstract

You have accessJournal of UrologyAdrenal1 Apr 201342 THE DEFINED DAILY DOSE CAN ASSESS POSTOPERATIVE CHANGE IN ANTIHYPERTENSIVE DRUG CONSUMPTION IN PATIENTS WITH PRIMARY ALDOSTERONISM Takanobu Utsumi, Mayuko Kaga, Tomokazu Sazuka, Mitsuru Yanagisawa, Kazuyoshi Nakamura, Takahito Suyama, Shinichi Sakamoto, Koji Kawamura, Naoto Kamiya, Takashi Imamoto, Naoki Nihei, Yukio Naya, Hiroyoshi Suzuki, and Tomohiko Ichikawa Takanobu UtsumiTakanobu Utsumi Chiba, Japan More articles by this author , Mayuko KagaMayuko Kaga Chiba, Japan More articles by this author , Tomokazu SazukaTomokazu Sazuka Chiba, Japan More articles by this author , Mitsuru YanagisawaMitsuru Yanagisawa Chiba, Japan More articles by this author , Kazuyoshi NakamuraKazuyoshi Nakamura Chiba, Japan More articles by this author , Takahito SuyamaTakahito Suyama Chiba, Japan More articles by this author , Shinichi SakamotoShinichi Sakamoto Chiba, Japan More articles by this author , Koji KawamuraKoji Kawamura Chiba, Japan More articles by this author , Naoto KamiyaNaoto Kamiya Sakura, Japan More articles by this author , Takashi ImamotoTakashi Imamoto Chiba, Japan More articles by this author , Naoki NiheiNaoki Nihei Chiba, Japan More articles by this author , Yukio NayaYukio Naya Ichihara, Japan More articles by this author , Hiroyoshi SuzukiHiroyoshi Suzuki Sakura, Japan More articles by this author , and Tomohiko IchikawaTomohiko Ichikawa Chiba, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1418AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The number of antihypertensive drug classes used does not accurately reflect total consumption of antihypertensive drugs to control blood pressure (BP), although it can become one of predictors for postoperative hypertension outcome in patients with primary aldosteronism (PA). The defined daily dose (DDD) was adopted to analyze consumption of many prescribed drugs. The aim of this study was to use the DDD to assess postoperative changes in antihypertensive drug consumption in PA patients. METHODS This retrospective study included 110 Japanese PA patients who underwent unilateral laparoscopic adrenalectomy between 1995 and 2012. Hyperaldosteronism was cured in all patients after surgery. After we defined the ratio of prescribed daily dose (PDD) to DDD (PDD/DDD) to estimate individual consumption of antihypertensive drugs, we calculated the pre- and postoperative PDD/DDD to assess total consumption change in antihypertensive drugs (Supplement). Uni- and multivariate analyses were performed to identify clinical predictors for ≥75% decrease in total PDD/DDD. RESULTS Total PDD/DDD decreased in 95.4% of patients postoperatively. The mean decrease in total PDD/DDD was 65.0%. A decrease in total PDD/DDD was significantly correlated with age, body mass index (BMI), duration of hypertension, estimated glomerular filtration rate (eGFR), and plasma renin activity (PRA). Postoperative decreases in total PDD/DDD ≥75% were confirmed in 52.7% of patients. Multivariate analysis identified no medical history of cardiovascular disease (odds ratio [OR] 5.4, P=0.02), lesser BMI (OR 1.2, P=0.03), and shorter duration of hypertension (OR 1.1, P<0.01) as independent predictors of postoperative decrease in total PDD/DDD ≥75%. Based on univariate analyses, additional factors associated with postoperative decrease in total PDD/DDD ≥75% included female sex, lower preoperative systolic BP, lower preoperative total PDD/DDD, greater eGFR, and lesser PRA (P<0.05). CONCLUSIONS Total PDD/DDD was shown to be a useful tool to assess total consumption change of antihypertensive drugs in PA patients. Clinicians can explain the predicted postoperative change of antihypertensive drug consumption to PA patients in detail using total PDD/DDD. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e17 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takanobu Utsumi Chiba, Japan More articles by this author Mayuko Kaga Chiba, Japan More articles by this author Tomokazu Sazuka Chiba, Japan More articles by this author Mitsuru Yanagisawa Chiba, Japan More articles by this author Kazuyoshi Nakamura Chiba, Japan More articles by this author Takahito Suyama Chiba, Japan More articles by this author Shinichi Sakamoto Chiba, Japan More articles by this author Koji Kawamura Chiba, Japan More articles by this author Naoto Kamiya Sakura, Japan More articles by this author Takashi Imamoto Chiba, Japan More articles by this author Naoki Nihei Chiba, Japan More articles by this author Yukio Naya Ichihara, Japan More articles by this author Hiroyoshi Suzuki Sakura, Japan More articles by this author Tomohiko Ichikawa Chiba, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...