title: Quality of life in patients with primary aldosteronism: gender differences in untreated and long-term treated patients and associations with treatment and aldosterone.
abstract: Psychopathological symptoms in patients with primary aldosteronism (PA) have been reported. In a cross-sectional design the self-reported physical and mental condition among patients with PA of the German Conn's Registry differently treated during the course of the disease were analysed. 27 patients were investigated before initiation of specific therapy (U), 56 patients were on chronic mineralocorticoid antagonist treatment (MRA) and 49 patients had undergone adrenalectomy (ADX). Patient's quality of life was analysed with the SF-12 for a Physical (PCS) and a Mental Component (MCS). Statistically significant lower scores for PCS were found for female PA patients treated with MRA in comparison to ADX patients and the German reference population (36.4 ± 11.1 vs. 49.1 ± 10.9 (p = 0.024) vs. 47.9 ± 9.7 (p = 0.001)), respectively. Concerning MCS, untreated female patients scored significantly lower (36.5 ± 7.4) than females from the German population (51.3 ± 8.4, p = 0.000). Furthermore, untreated females appear to differ significantly from MRA and ADX females, scoring the lowest reading (U vs. MRA: p = 0.029; U vs. ADX: p = 0.005). Significant correlations were found between plasma aldosterone (r = -0.819, p = 0.013) and the MCS and between plasma renin concentration and MCS (r = -0.938, p = 0.001) in female MRA patients. In summary, PA patients report a worse physical and mental condition than the one reported for the German reference population. Untreated and mineralocorticoid antagonist treated patients report the lowest readings. Females were found to be more impaired than males in QoL. MRA treatment seems to affect the MCS of female patients.
authors.affiliation: Medizinische Klinik Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, Ziemssenstr. 1, D-80336 München, Germany. Heike.Kuenzel@med.uni-muenchen.de
authors.forename: Heike E
authors.initials: HE
authors.lastname: Künzel
authors.forename: Konstantina
authors.initials: K
authors.lastname: Apostolopoulou
authors.forename: Anna
authors.initials: A
authors.lastname: Pallauf
authors.forename: Sabine
authors.initials: S
authors.lastname: Gerum
authors.forename: Katrin
authors.initials: K
authors.lastname: Merkle
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schulz
authors.forename: Evelyn
authors.initials: E
authors.lastname: Fischer
authors.forename: Volker
authors.initials: V
authors.lastname: Brand
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: Stephan
authors.initials: S
authors.lastname: Endres
authors.forename: Felix
authors.initials: F
authors.lastname: Beuschlein
authors.forename: Martin
authors.initials: M
authors.lastname: Reincke
mesh_terms: D000315:Adrenalectomy / Q000523:psychology; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D005260:Female; D005858:Germany; D006801:Humans; D006929:Hyperaldosteronism / Q000188:drug therapy / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D011788:Quality of Life; D012042:Registries; D012083:Renin / Q000097:blood; D013148:Spironolactone / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D012083:Renin