Evaluation of Predictive Risk Factors of Persistent Hypertension in Hyperaldosteronism After Surgery

AuthorAmal Ourdien
AuthorYoussra Laalaouaen
AuthorImane Assarraren
AuthorBouichrat Nisrineen
AuthorSiham Roufen
AuthorHanane Latrechen
OrcidAmal Ourdi [0009-0001-6921-1960]en
OrcidSiham Rouf [0000-0003-0624-6207]en
OrcidHanane Latrech [0000-0001-9945-6857]en
Issued Date2025-04-30en
AbstractBackground: Primary hyperaldosteronism (PHA) is a common cause of secondary arterial hypertension (AH), characterized by autonomous aldosterone secretion. It is frequently underdiagnosed and may persist even after surgical intervention. Objectives: The present study aimed to identify preoperative factors that could predict whether hypertension would persist or normalize following surgery and to outline relevant diagnostic characteristics. Methods: We conducted a descriptive, analytic, retrospective cohort study at a single center. The study included patients with PHA who were followed up at the Department of Endocrinology, Diabetology, and Nutrition in a hospital affiliated with Mohamed the First University of Oujda (CERBO), admitted between December 2014 and August 2023. Data were retrospectively collected from patient records over a 9-year period, involving 27 patients with PHA confirmed by an elevated aldosterone-to-renin ratio (ARR). Persistent disease was defined by persistent hypokalemia and hypertension (blood pressure > 140/90 mm Hg) after six months. Patients were divided into two groups: Those with complete resolution of hypertension (group A) and those with persistent hypertension (group B). Data were analyzed using SPSS version 21. Results: The mean age of patients was 48.47 ± 10.87 years, with a female predominance (66.7%). The etiological assessment identified Conn’s adenoma in 70.4% (n = 19) of cases and bilateral adrenal hyperplasia in 29.6% (n = 8). Surgery was performed in 51.9% (n = 14) of cases, with 50% (n = 7) maintaining persistent hypertension post-surgery, while 28.6% (n = 4) showed a reduction in antihypertensive medications. Two predictive factors for persistent hypertension were identified: Age > 50 years and hypertension duration > 5 years. Predictive factors for normalization of hypertension post-surgery included systolic blood pressure (SBP) < 140 mm Hg, diastolic blood pressure (DBP) < 90 mm Hg, glomerular filtration rate (GFR) > 90 mL/min/1.75 m2, and a low incidence of diabetes and dyslipidemia. Conclusions: This study demonstrates that PHA can lead to resistant hypertension, highlighting the necessity for further research in this area.en
DOIhttps://doi.org/10.5812/ijem-156728en
URIhttps://brieflands.com/journals/ijem/articles/156728en
KeywordPrimary Hyperaldosteronismen
KeywordEndocrine Hypertensionen
KeywordConn’s Adenomaen
KeywordAdrenal Glanden
KeywordPersistent Hypertensionen
KeywordPredictive Factorsen
PublisherBrieflandsen
TitleEvaluation of Predictive Risk Factors of Persistent Hypertension in Hyperaldosteronism After Surgeryen
TypeResearch Articleen

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