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UNEXPECTED INCIDENCE OF LOW BLOOD PRESSURE 2 YEARS AFTER UNILATERAL ADRENALECTOMY FOR PRIMARY ALDOSTERONISM
Author(s) -
Gordon Richard D.,
Hawkins Peter G.,
Hamlet Stephen M.,
Tunny Terry J.,
Klemm Shelley A.,
Backmann Anthony W.,
Finn Wendy L.
Publication year - 1989
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/j.1440-1681.1989.tb01558.x
Subject(s) - primary aldosteronism , medicine , adrenalectomy , blood pressure , incidence (geometry) , endocrinology , physics , optics
SUMMARY 1. Serial observations of blood pressure after unilateral adrenalectomy for aldosterone‐producing adenoma revealed an incidence of hypotension (systolic BP < fifth percentile for age‐ and sex‐matched normal population) of 27% at 2 years, more than 5 times that predicted. 2. Serial observations of volume regulatory hormones showed significantly raised mean levels of plasma renin activity consistent with hypovolaemia. Significantly reduced mean aldosterone levels despite significantly raised mean plasma renin activity levels may reflect reduced responsiveness of the remaining adrenal. 3. Reduction of significantly elevated preoperative ANP levels to significantly reduced levels postoperatively is also in keeping with postoperative hypovolaemia. 4. A 50% reduction in plasma adrenaline after unilateral adrenalectomy might contribute to reduced noradrenergic activity (prejunctional β‐receptor) and reduced blood pressure, but plasma noradrenaline did not fall significantly postoperatively. 5. Postoperative levels of renin, aldosterone, adrenaline and noradrenaline were not significantly different between those who did, and those who did not, become hypotensive.