Study of the Predictive Factors of Postoperative Blood Pressure in Cases with Primary Aldosteronism

Abstract

Some patients develop hypertension after adrenalectomy for primary aldosteronism. We treated 60 cases with primary aldosteronism, and the percentages of cases manifesting hypertensive blood pressures after operation were as follows: 40.0% at the first month, 24.2% at the second year, 30.4% at the 5th year after operation. What are the most important clinical factors relating to postoperative blood pressure? Knowledge of those factors would help in predicting the postoperative blood pressure in cases with primary aldosteronism. The relationships between the postoperative blood pressure and several clinical factors were evaluated for a certain postoperative period using multiple regression analyses. The results were as follows: 1. The duration of preoperative hypertension is the major determinant at the second month after operation. 2. The histological findings for the kidney are the major determinant at the 6th month and the first year after operation. 3. At the second year postoperation, the histological findings for the kidney and the familial history of hypertension are the major determinant respectively. 4. The familial history of hypertension is the most determinant at the 5th year after operation. It is concluded that the preoperative duration of hypertension and the histological findings for the kidney are helpful in predicting blood pressure during the first 2 years after operation, while the familial history of hypertension influences the postoperative blood pressure thereafter.