title: Implication of aortic calcification on persistent hypertension after laparoscopic adrenalectomy in patients with primary aldosteronism.
abstract: To identify risk factors, including aortic calcification, for persistent hypertension in primary aldosteronism patients undergoing laparoscopic adrenalectomy.
  
  
  
  Between October 2000 and October 2015, we carried out 101 consecutive laparoscopic adrenalectomies for unilateral primary aldosteronism. Of these, 95 cases with at least 1 year of postoperative follow up were included. These were divided into two study groups based on whether they had normal blood pressure without antihypertensive medications (resolved group) or still required medications (unresolved group) at 1 year after surgery. Variables included age, sex, body mass index, history of hypertension, dosage of antihypertensive medication score, presence of type 2 diabetes, subclinical Cushing syndrome, preoperative renal function, aldosteronoma resolution score and abdominal calcification index. Univariate and multivariate logistic regression analyses were used to assess independent risk factors for persistent hypertension 1 year after surgery.
  
  
  
  The complete resolution of hypertension without antihypertensive medication 1 year after adrenalectomy was 36 out of 95 (38%). The preoperative antihypertensive medication score, systolic blood pressure and abdominal calcification index were significantly higher, and the aldosteronoma resolution score were significantly lower in the unresolved group than in the resolved group. Using multivariate logistic regression analysis, independent risk factors significantly correlating with persistent hypertension 1 year after surgery were aldosteronoma resolution score and abdominal calcification index.
  
  
  
  Laparoscopic adrenalectomy for primary aldosteronism is effective in improving blood pressure and reducing the need for antihypertensive medications. Aldosteronoma resolution score and abdominal calcification index represent potential independent risk factors for persistent hypertension 1 year after surgery.
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Naoki
authors: N
authors: Fujita
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Shingo
authors: S
authors: Hatakeyama
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Hayato
authors: H
authors: Yamamoto
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Yuki
authors: Y
authors: Tobisawa
authors: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Tohru
authors: T
authors: Yoneyama
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Takahiro
authors: T
authors: Yoneyama
authors: Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Yasuhiro
authors: Y
authors: Hashimoto
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Takuya
authors: T
authors: Koie
authors: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Takeshi
authors: T
authors: Nigawara
authors: Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.|Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Chikara
authors: C
authors: Ohyama
mesh_terms: D000315:Adrenalectomy; D001018:Aortic Diseases / Q000150:complications*; D002114:Calcinosis / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications*; D006973:Hypertension / Q000209:etiology*; D010535:Laparoscopy; D012189:Retrospective Studies; D012307:Risk Factors
keywords: aldosteronoma resolution score; aortic calcification; laparoscopic adrenalectomy; persistent hypertension; primary aldosteronism