486 The implication of aortic calcification on persistent hypertension after laparoscopic adrenalectomy in patients with primary aldosteronism

Abstract

Abstract:Objectives: To identify risk factors, including aortic calcification, for persistent hypertension in primary aldosteronism (PA) patients who underwent laparoscopic adrenalectomies. Methods:Between October 2000 and October 2015, we performed consecutive 101 laparoscopic adrenalectomies for unilateral PA patients. Of those, 95 patients who had at least one year follow-up periods were included. The patients were divided into two groups based on whether they had normal blood pressure without antihypertensive medications (resolved group) or still required medications (unresolved group) at one year after surgery.Variables included age, gender, body mass index, history of hypertension, dosage of antihypertensive medication score, presence of type 2 diabetes, subclinical Cushing syndrome, preoperative renal function, aldosteronoma resolution score (ARS), and abdominal calcification index (ACI). Univariate and multivariate logistic regression analyses were used to assess independent risk factors for persistent hypertension one year after surgery. Results:The complete resolution of hypertension without antihypertensive medication one year after adrenalectomy was 36/95 (38%). Preoperative antihypertensive medication score, systolic blood pressure, ACI were significantly higher, and ARS were significantly lower in the unresolved group than in the resolved group. Using multivariate logistic regression analysis, independent risk factors significantly correlating with persistent hypertension one year after surgery were ARS and ACI. Conclusions:Adrenalectomy improved blood pressure and the need for antihypertensive medications, whereas ARS and ACI were potential independent risk factors for persistent hypertension one year after adrenalectomy.