Blood Pressure Change in Patients with a Benign Adrenal Tumor after Unilateral Adrenalectomy

Abstract

Forty-four patients with hypertension who were diagnosed with benign adrenal tumor (adenoma or hyperplasia) underwent unilateral adrenalectomy from 1984 to 1992 and were followed long-term. Forty of the 44 with a definite functional diagnosis (such as primary aldosteronism, Cushing’s syndrome and pheochromocytoma) had dramatic improvement of their hypertension immediately after the surgery, and this recovery persisted. After one year of follow-up, 71.4% became normotensive, 25.7% had mild hypertension and only 2.9% had persistent hypertension. The improvement in the hypertension and the percentage of patients who returned to normal was most notable in those with pheochromocytoma. The improvement in blood pressure was more gradual in patients with primary aldosteronism and Cushing’s syndrome. Four patients with hypertension only were found to have either adrenal adenoma or hyperplasia. On functional evaluation, they were not found to have any definite endocrinologic abnormality. Unilateral adrenalectomy resulted in only temporary improvement in three of these patients, and all four remained hypertensive on long term follow-up.