title: Effectiveness of partial adrenalectomy for concomitant hypertension in patients with nonfunctional adrenal adenoma.
abstract: OBJECTIVE
  To evaluate the effect of adrenal surgery on blood pressure (BP) in patients with both nonfunctional adrenal adenoma (NFA) and hypertension and to assess factors affecting hypertension outcomes after surgery.
  
  
  METHODS
  Nonfunctional adrenal adenoma patients with hypertension who were treated with or without adrenal surgery at our center during 2005-2011 were retrospectively studied. Clinical characteristics were collected, and changes in BP were evaluated and compared at 2 year after discharge. Factors predicting favorable hypertension outcomes after surgery were determined using logistic regression.
  
  
  RESULTS
  A total of 186 patients, including 77 surgically treated cases, were eligible for this study. Retroperitoneoscopic procedure was mostly adopted, and partial adrenalectomy was performed in 69 patients. At 2 year postoperatively, both systolic and diastolic pressure levels of the surgery group decreased significantly (162.9/97.6 vs. 146.9/88.2 mmHg), with 27 (35%) patients cured and 26 (31%) improved. In contrast, BP levels of conservatively treated patients remained relatively stable (159.9/96.8 vs. 161.9/97.4 mmHg) after 2 years. Multivariate logistic regression analyses showed hypertension duration<6 years was the only independent factor associated with favorable hypertension outcomes after surgery, which predicted complete cure as well as response to surgical intervention.
  
  
  CONCLUSIONS
  Early partial adrenalectomy substantially cures or improves concomitant hypertension in most patients with NFA. Prospective studies should be performed of large cohorts to construct ideal clinical guidelines for NFA patients at cardiometabolic risk.
authors.affiliation: Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
authors.forename: Tianyuan
authors.initials: T
authors.lastname: Xu
authors.forename: Leilei
authors.initials: L
authors.lastname: Xia
authors.forename: Xianjin
authors.initials: X
authors.lastname: Wang
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Zhang
authors.forename: Shan
authors.initials: S
authors.lastname: Zhong
authors.forename: Liang
authors.initials: L
authors.lastname: Qin
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhu
authors.forename: Zhoujun
authors.initials: Z
authors.lastname: Shen
mesh_terms: D000236:Adenoma / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000328:Adult; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome