Adrenalectomy Improves Arterial Stiffness in Primary Aldosteronism | Zendy

Branislav Štrauch | Zendy; Ondřej Petrák | Zendy; Tomáš Zelinka | Zendy; Dan Wichterle | Zendy; Robert Holaj | Zendy; M Kasalický | Zendy; L Šafařík | Zendy; J. Rosa | Zendy; J Widimský | Zendy

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Adrenalectomy Improves Arterial Stiffness in Primary Aldosteronism

Author(s) -

Branislav Štrauch,

Ondřej Petrák,

Tomáš Zelinka,

Dan Wichterle,

Robert Holaj,

M Kasalický,

L Šafařík,

J. Rosa,

J Widimský

Publication year - 2008

Publication title -

american journal of hypertension

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.009

H-Index - 136

eISSN - 1941-7225

pISSN - 0895-7061

DOI - 10.1038/ajh.2008.243

Subject(s) - medicine , primary aldosteronism , spironolactone , aldosterone , blood pressure , arterial stiffness , adrenalectomy , pulse wave velocity , cardiology , urology , adrenocortical adenoma , heart rate , endocrinology , adenoma

BackgroundAldosterone has been shown to substantially contribute to the accumulation of different types of collagen fibers and growth factors in the arterial wall, which increase wall stiffness. We previously showed that arterial wall stiffness is increased in primary aldosteronism (PA) independently of concomitant hypertension. This study was aimed at assessing the effects of specific treatment of PA on the arterial stiffness.MethodsTwenty-nine patients with confirmed PA (15 with aldosterone-producing adenoma treated by unilateral laparoscopic adrenalectomy, 14 treated with spironolactone (mainly idiopathic aldosteronism) were investigated by Sphygmocor applanation tonometer (using measurement of carotid-femoral pulse wave velocity (PWV) and augmentation index (AI)) at the time of the diagnosis and then approximately 1 year after the specific treatment.ResultsThe office blood pressure (BP) decreased from 167 +/- 18/96 +/- 9 to 136 +/- 12/80 +/- 7 mm Hg after adrenalectomy (P = 0.001), and from 165 +/- 21/91 +/- 13 to 151 +/- 22/88 +/- 8 mm Hg (not significant (n.s.)) on spironolactone. The mean 24-h BP decreased from 150 +/- 18/93 +/- 11 mm Hg to 126 +/- 17/80 +/- 10 mm Hg after adrenalectomy (P < 0.01), and from 155 +/- 16/94 +/- 12 to 139 +/- 18/88 +/- 8 mm Hg (n.s.) on spironolactone. The PWV significantly decreased after surgery from 9.5 +/- 2.7 m/s to 7.6 +/- 2 m/s (P = 0.001), and the AI (recalculated for heart rate 75/min) decreased significantly from 27 +/- 10 to 19 +/- 9% (P < 0.01). On the other hand, we did not find significant change of arterial stiffness indices in patients treated with spironolactone (PWV: 9.3 +/- 1.6 m/s vs. 8.8 +/- 1.3 m/s (n.s.); AI: 25 +/- 9% vs. 25 +/- 8% (n.s.)).ConclusionsSurgical but not conservative treatment of PA led to a significant decrease of BP and arterial stiffness parameters.American Journal of Hypertension (2008). doi:10.1038/ajh.2008.243American Journal of Hypertension (2008); 21, 10, 1086-1092. doi 10.1038/ajh.2008.243.

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