Clinical Research Papers:
Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery
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Juping Zhao1,*, Jun Dai1,*, Wenlong Zhou1, Haofei Wang1, Wenbin Rui1, Wei He1, Zhe Zhu2,3, Yu Zhu1, Danfeng Xu1 and Fukang Sun1
1Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
2Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, 92037 USA
3Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195 USA
*These authors contributed equally to this work
Fukang Sun, email: [email protected]
Keywords: aldosterone-producing adenoma, predictor, hypertension urgency, laparoscopic adrenalectomy
Received: July 04, 2017 Accepted: September 21, 2017 Published: October 07, 2017
Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed. The factors included gender, age, body mass index, preoperative maximum systolic blood pressure, number of antihypertensive medicines, preoperative spironolactone treatment, duration of hypertension, surgical method and approach, adenoma diameter, preoperative proteinuria, estimated glomerular filtration rate, serum potassium and serum aldosterone. Univariate and multivariate regression analyses were used to evaluate the relationship between the above variables and postoperative hypertension urgency. We found that the proportion of patients with a higher systolic blood pressure ≥ 160 mmHg and ≥ 180 mmHg were significantly increased post-operation (both p < 0.001). In multivariate analysis, the maximum systolic blood pressure was an independent predictor of postoperative hypertension urgency, and the cut-off point was 157 mmHg with the sensitivity of 66% and specificity of 82%. Multivariable analysis also showed that preoperative maximum systolic blood pressure and number of antihypertensive medicines were independent risk factors for higher postoperative systolic blood pressure. This study was derived from a high volume adrenal tumor center, and these data may provide a potential tool to guide preoperative counseling.
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