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Open Access 14-07-2023 | Adrenalectomy | Original Scientific Report

The Impact of Obesity on the Resolution of Hypertension Following Adrenalectomy for Primary Hyperaldosteronism

Authors: Swathikan Chidambaram, Klaas Van Den Heede, Samir Damji, Karim Meeran, Jeannie Todd, Florian Wernig, Fausto Palazzo, Aimee N. Di Marco

Published in: World Journal of Surgery | Issue 9/2023

Abstract

Background

This study aims to determine the impact of patient obesity on the resolution of hypertension and pill burden post-adrenalectomy for PA. Primary hyperaldosteronism (PA) is the most common cause of secondary hypertension that may be remedied with surgery (unilateral adrenalectomy). Obesity may independently cause hypertension through several mechanisms including activation of the renin–angiotensin–aldosterone pathway. The influence of obesity on the efficacy of adrenalectomy in PA has not been established.

Methods

This is a retrospective analysis of prospectively collected data on patients undergoing adrenalectomy for PA at a single, tertiary-care surgical centre from January 2015 to December 2020. Electronic health records of patients were screened to collect relevant data. The primary outcomes of the study include post-operative blood pressure, the reduction in the number of anti-hypertensive medications and potassium supplementation burden post-adrenalectomy.

Results

Fifty-three patients were included in the final analysis. There was a significant reduction in the blood pressure and the number of anti-hypertensive medications in all patients after adrenalectomy (p < 0.001). Of the 34 patients (64.2%) with pre-operative hypokalaemia, all became normokalaemic and were able to stop supplementation. However obese patients required more anti-hypertensive medications to achieve an acceptable blood pressure than overweight or normal BMI patients (p < 0.01). Multivariate logistic regression analysis showed that male gender and BMI were independent predictors of resolution of hypertension (p <0.01).

Conclusion

Unilateral adrenalectomy improves the management of hypertension and hypokalaemia when present in patients with PA. However, obesity has an independent deleterious impact on improvement in blood pressure post-adrenalectomy for PA.

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Title: The Impact of Obesity on the Resolution of Hypertension Following Adrenalectomy for Primary Hyperaldosteronism
Authors: Swathikan Chidambaram
Klaas Van Den Heede
Samir Damji
Karim Meeran
Jeannie Todd
Florian Wernig
Fausto Palazzo
Aimee N. Di Marco
Publication date: 14-07-2023
Publisher: Springer International Publishing
Keywords: Adrenalectomy
Adrenalectomy
Hyperaldosteronism
Hypertension
Obesity
Obesity
Hypertension
Published in: World Journal of Surgery / Issue 9/2023
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-023-07021-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Impact of Obesity on the Resolution of Hypertension Following Adrenalectomy for Primary Hyperaldosteronism

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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