title: Time course and factors predicting arterial stiffness reversal in patients with aldosterone-producing adenoma after adrenalectomy: prospective study of 102 patients.
abstract: Primary aldosteronism not only results in hypertension but also stiffer arteries. The time course and factors predicting the reversal of arterial stiffness after treatment are unclear. We prospectively enrolled 102 patients with aldosterone-producing adenoma (APA) from March 2006 to January 2012. We measured the pulse wave velocity (PWV) between brachial-ankle (baPWV) and heart-ankle (haPWV) before, 6 and 12 months after their adrenalectomy. After treatment, the PWV decreased significantly during the first 6 months (both p < 0.001), but no further reduction in the following 6 months. The determinant factors for baseline baPWV were age, duration of hypertension, and baseline systolic blood pressure (SBP) in multivariate linear regression analysis, similar with baseline haPWV (determinants: age, duration of hypertension, baseline SBP and diastolic blood pressure (DBP)). In multivariate linear regression analysis, the decrease in DBP at 6 months (ΔDBP0-6mo) and baseline baPWV were significantly associated with the decrease in baPWV at 6 months (ΔbaPWV0-6mo). The associated factors of the change in haPWV at 6 months (ΔhaPWV0-6mo) were baseline haPWV, ΔDBP0-6mo and change in log-transformed plasma renin activity. Our result suggested that reversal of arterial stiffness in APA patients occurred early after adrenalectomy and determined by baseline vascular condition, hemodynamic factors, and humoral factors.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
authors.forename: Che-Wei
authors.initials: CW
authors.lastname: Liao
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Chi-Sheng
authors.initials: CS
authors.lastname: Hung
authors.affiliation: Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taiwan.
authors.forename: Yen-Tin
authors.initials: YT
authors.lastname: Lin
authors.affiliation: Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Yi-Yao
authors.initials: YY
authors.lastname: Chang
authors.affiliation: Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Shuo-Meng
authors.initials: SM
authors.lastname: Wang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yi-Lwun
authors.initials: YL
authors.lastname: Ho
authors.affiliation: Division of Nephrology, Endocrinology, and Vascular Medicine, Departments of Medicine, Tohoku University Hospital, Sendai, Japan.
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Satoh
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000450:Aldosterone / Q000096:biosynthesis*; D055109:Ankle Brachial Index; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D059289:Vascular Stiffness
chemical_list: D000450:Aldosterone