title: Hypertension and hypertensive cardiomyopathy in patients with a relapse-free history of phaeochromocytoma.
abstract: BACKGROUND
  In patients with a relapse-free history of phaeochromocytoma/paraganglioma (PCC/PGL), persistent hypertension has been reported, but has not been well characterized.
  
  
  METHODS
  In 28 patients [mean age 54·5 (26-81) years] with a relapse-free history of PCC/PGLs, we prospectively analysed resting, supine blood pressure (BP), ambulatory BP, echocardiography, exercise testing, metabolic parameters and retrospectively collected data from the time of diagnosis (baseline). Echocardiographic measures were compared to healthy (n = 28) and hypertensive controls (n = 15).
  
  
  RESULTS
  Median follow-up was 6 [1-16] years. Three patients had normal office and ambulatory BP and three patients had only increased office BP. Fifty-four per cent of patients had a blunted circadian rhythm. Comparing normal, hypertensive and PCC/PGL patients, we found significant differences in end-diastolic septal thickness (8·8 ± 0·2, 13·8 ± 0·4, 10·0 ± 0·3 mm, P < 0·05), septal basal thickness (9·0 ± 0·3, 15·9 ± 0·5, 11·2 ± 0·4 mm, P < 0·05) and left ventricular mass (143 ± 8, 255 ± 19, 169 ± 9 g, P < 0·05). In five patients, seven major cardiovascular events were observed. Compared to baseline, no significant difference was found in systolic (140 ± 35 vs 137 ± 18 mmHg) and diastolic (85 ± 18 vs 83 ± 10 mmHg) BP. An increase or a decrease in BP (>10 mmHg) was found in 36% and 39% of patients, respectively. The number of antihypertensive drugs had not changed [1 (0-3) vs 1 (0-4)]. Fewer patients received insulin (1 vs 3) or oral antiglycaemic drugs (2 vs 7).
  
  
  CONCLUSIONS
  Our data indicate that hypertension persists after removal of PCG/PGL in a substantial proportion of patients. Hypertensive heart disease is common, and cardiovascular events are frequent in patients with a history of PCC/PGL.
authors.affiliation: Department of Internal Medicine I, Endocrine Unit, University Hospital, University of Wuerzburg, Wuerzburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Weismann
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.forename: Till
authors.initials: T
authors.lastname: Bergen
authors.forename: Mirko
authors.initials: M
authors.lastname: Peitzsch
authors.forename: Anna
authors.initials: A
authors.lastname: Raida
authors.forename: Martin
authors.initials: M
authors.lastname: Wagner
authors.forename: Martin
authors.initials: M
authors.lastname: Fassnacht
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
authors.forename: Bruno
authors.initials: B
authors.lastname: Allolio
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D018572:Disease-Free Survival; D004452:Echocardiography; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008875:Middle Aged; D010235:Paraganglioma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D010673:Pheochromocytoma; D012008:Recurrence