Reversal of arterial stiffness in medically and surgically treated unilateral primary aldosteronism.
J Hypertens
; 42(3): 538-545, 2024 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-38088428
ABSTRACT
OBJECTIVE:
Hyperaldosteronism has adverse effects on cardiovascular structure and function. Laparoscopic adrenalectomy is the gold standard for patients with unilateral primary aldosteronism. For unilateral primary aldosteronism patients unable or unwilling to undergo surgery, the effects of mineralocorticoid receptor antagonists (MRAs) on the reversibility of arterial stiffness and other clinical data remain unclear. We aimed to compare the reversibility of arterial stiffness using pulse wave velocity (PWV) and other clinical parameters between surgically and medically treated unilateral primary aldosteronism patients.METHODS:
We prospectively enrolled 306 unilateral primary aldosteronism patients, of whom 247 received adrenalectomy and 59 received medical treatment with MRAs. Detailed medical history, basic biochemistry and PWV data were collected in both groups before treatment and 1âyear after treatment. After propensity score matching (PSM) for age, sex, SBP and DBPs, 149 patients receiving adrenalectomy and 54 patients receiving MRAs were included for further analysis.RESULTS:
After PSM, the patients receiving adrenalectomy had a greater reduction in blood pressure, increase in serum potassium, and change in PWV (ΔPWV, -53â±â113 vs. -10â±â140âcm/s, P â=â0.028) than those receiving MRAs 1âyear after treatment. Multivariable regression analysis further identified that surgery (compared with MRA treatment), baseline PWV, baseline DBP, the change in DBP and the use of diuretics were independently correlated with ΔPWV.CONCLUSION:
Adrenalectomy is superior to MRA treatment with regards to vascular remodeling when treating unilateral primary aldosteronism patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Rigidez Vascular
/
Hiperaldosteronismo
Limite:
Humans
Idioma:
En
Revista:
J Hypertens
Ano de publicação:
2024
Tipo de documento:
Article