Rare normalization of blood pressure after unilateral adrenalectomy in 31 patients with Conn syndrome.
BACKGROUND
Adrenal tumor excision in patients with Conn syndrome is not always followed by normalization of blood pressure (BP). The aim of the study was to determine predictors of persistent hypertension during long-term observation after adrenalectomy.


METHODS
Thirty-one patients (23 F and 8 M) with Conn syndrome and adrenal tumor subjected to unilateral adrenalectomy were included. The duration of hypertension ranged from 1 to 30 years and observation time from 1 to 10 years.


RESULTS
Beneficial impact of adrenalectomy on BP control was found in 25 patients, including only 10 patients with BP normalization. Patients with normalization of BP were significantly younger [41 (36-46) vs 53 (48-57) years; p = 0.002] and had lower pulse BP [72 (56-89) vs 93(80-106) mmHg; p = 0.03]. Significant decline of maximal values of systolic and diastolic BP after surgery was observed [59 (47-72) and 29 (20-37) mmHg, respectively]. The analysis revealed that age over 50 years and pulse BP over 70 mmHg predict the persistence of hypertension after surgery.


CONCLUSIONS
Normalization of BP after adrenalectomy is observed only in 32% of patients with Conn syndrome regardless the normalization of hypokalemia. BP normalization in long period observation was more frequently found in younger patients with lower pulse BP.
Ziaja
Jacek
J
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, ul. Francuska 20-24, 40-027 Katowice, Poland. ziacek@mp.pl
Chudek
Jerzy
J
Król
Robert
R
Pawlicki
Jacek
J
Wiecek
Andrzej
A
Cierpka
Lech
L
D000315:Adrenalectomy; D000367:Age Factors; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000503:physiopathology*; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012307:Risk Factors