title: [Long-term blood pressure outcome after unilateral adrenalectomy for primary hyperaldosteronism].
abstract: OBJECTIVE
  To evaluate long-term results of adrenalectomy for primary aldosteronism (PA) and to identify prognostic factors associated.
  
  
  METHODS
  Exhaustive retrospective review of all consecutive patients undergoing adrenalectomy for PA between 2002 and 2013 in our department. All patients underwent preoperative: clinical evaluation (age, sex, height, weight, systolic and diastolic BP under treatment, identification of anti-hypertension treatment), biological evaluation (potassium, renin, aldosterone) and radiological evaluation (CT and/or MRI). Blood pressure was assessed postoperatively at 1 month, 1 year, then at the date of the latest news. The patients were classified into three categories: cured (no antihypertensive therapy in postoperative associated with strictly lower blood pressures of 140/90mmHg), improved (decreased number of drugs or number unchanged but with better blood pressure control), and refractory (no change in the number of drug and blood pressure, or deterioration of one or other of these two parameters).
  
  
  RESULTS
  We evaluated 43 patients, 23 men and 20 women, with a median follow-up of 74.4 months [16.8 to 141]. Pathological analysis described 34 adenomas (79%), 7 hyperplasias (16%) (5 micro-nodular and 2 macro-nodular) and 2 adrenocortical carcinoma (5%). The postoperative long-term assessment found 20% of cured patients (n=8), 65% of improved (n=26) and 15% of refractory (n=6). Prognostic factors associated with favorable long-term blood pressure outcome were those typically associated with ARS score [preoperative number of anti-hypertension drugs (P=0.005), BMI<25kg/m2(P=0.009), and duration of hypertension (P=0.007)].
  
  
  CONCLUSIONS
  Adrenalectomy for PA is a long-term effective treatment for blood pressure control. Prognostic factors associated with long-term success are those conventionally described in ARS score.
  
  
  METHODS
  4.
authors.affiliation: Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Laboratoire de recherche HeRVI EA3801, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France; Centre de ressources biologiques, biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France. Electronic address: fabiensaint@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Saint
authors.affiliation: Service d'urologie - transplantation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
authors.forename: R
authors.initials: R
authors.lastname: Prader
authors.affiliation: Service d'anatomie et cytologie pathologiques, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
authors.forename: C
authors.initials: C
authors.lastname: Cordonnier
authors.affiliation: Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
authors.forename: G
authors.initials: G
authors.lastname: Choukroun
authors.affiliation: Service de néphrologie, médecine interne, dialyse, transplantation et réanimation, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
authors.forename: N
authors.initials: N
authors.lastname: Elesper
authors.affiliation: Service d'endocrinologie, maladies métaboliques, diabétologie et nutrition, université de Picardie Jules-Verne, CHU d'Amiens, 80000 Amiens, France.
authors.forename: R
authors.initials: R
authors.lastname: Desailloud
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000601:surgery*; D006973:Hypertension / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Adrenalectomy; Blood pressure; Follow-up; Hyperaldostéronisme primaire; Pression artérielle; Primary hyperaldosteronism; Suivi; Surrénalectomie