title: Essential hypertension: first reason for persistent hypertension after unilateral adrenalectomy for primary aldosteronism?
abstract: BACKGROUND
  Despite cure of primary aldosteronism by surgical resection, hypertension persists postoperatively in 30% to 50% of patients. The aim of this study was to determine factors influencing long-term outcome of blood pressure after unilateral adrenalectomy for primary aldosteronism.
  
  
  METHODS
  Records of 100 patients who underwent unilateral adrenalectomy for primary aldosteronism from 1970 through 1997 were reviewed. Patients were distributed in 2 groups according to whether blood pressure was normal (criteria of World Health Organization). Clinical, biochemical, and pathologic data were compared.
  
  
  RESULTS
  All patients were biochemically cured. Blood pressure was normal in 56 patients and improved in 44 (mean follow-up, 69 and 59 months). Persistent hypertension correlated with age, known duration and seriousness of preoperative hypertension, family history of hypertension, no preoperative response to spironolactone, and contralateral adrenal hypertrophy. Gender, surgical approach, and pathologic findings were not predictive factors of blood pressure outcome. The prevalence of hypertension was almost the same in these postoperative patients as the prevalence of essential hypertension in a random population of the same age.
  
  
  CONCLUSIONS
  Early unilateral adrenalectomy allows cure or improvement of hypertension in all patients with primary aldosteronism induced by unilateral excessive source of aldosterone secretion regardless of the pathologic findings. Persistent hypertension suggests that coexisting essential hypertension is present.
authors.affiliation: Department of General and Endocrine Surgery, Lille University Hospital, France.
authors.forename: C A
authors.initials: CA
authors.lastname: Proye
authors.forename: E A
authors.initials: EA
authors.lastname: Mulliez
authors.forename: B M
authors.initials: BM
authors.lastname: Carnaille
authors.forename: M
authors.initials: M
authors.lastname: Lecomte-Houcke
authors.forename: M
authors.initials: M
authors.lastname: Decoulx
authors.forename: J L
authors.initials: JL
authors.lastname: Wémeau
authors.forename: J
authors.initials: J
authors.lastname: Lefebvre
authors.forename: A
authors.initials: A
authors.lastname: Racadot
authors.forename: O
authors.initials: O
authors.lastname: Ernst
authors.forename: D
authors.initials: D
authors.lastname: Huglo
authors.forename: A
authors.initials: A
authors.lastname: Carré
mesh_terms: D000293:Adolescent; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000601:surgery*; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged