Predictive Factors for Complete Resolution of Hypertension After Adrenalectomy for Aldosteronoma

Abstract

Introduction: Primary hyperaldosteronism, 1st cause of secondary hypertension, 2nd cause of hypertension potentially curable by surgery. The objective of this work is to determine the predictive factors for complete resolution of hypertension after adrenalectomy. Material: We conducted a retrospective study of 25 patients with primary hyperaldosteronism operated and followed between 1985 and 2018. Results: Our patients were divided into 16 women and 9 men, mean age 54 years. 40% of our patients were smokers, 36% dyslipidemic, 68% diabetic and 76% had a BMI ≥ 25 kg / m2. Patients underwent unilateral adrenalectomy, the surgical approach was posterior lumbar in 9 cases and laparoscopic in 16 cases. No per or postoperative complication was noted. The postoperative course was marked by the HTA in 36% of the cases, an improvement in 36% of the cases and persistence in 31% of the cases. We found a significant decrease of the PAS and the PAD at six months of the surgery. The comparative study of the patients whose HTA was cured versus unhealed did not show a statistically significant correlation with the following predictors of healing: young age, female gender, lack of family history of hypertension, adenoma’s dimension, the presence of comorbidities including diabetes and dyslipidemia and the average number of antihypertensive treatment.Only the absence of overweight or obesity was a predictor of healing in our series. Conclusion: Knowing the predictive factors of healing aims to pose the operative indication and especially to improve the prognosis of hypertension after surgery by acting on certain modifiable factors.