Open AccessAdrenal Venous Sampling for Primary Aldosteronism and Clinical Outcomes After Unilateral Adrenalectomy: A Single‐Center Experience
Author(s) -
Murashima Miho,
Trerotola Scott O.,
Fraker Douglas L.,
Han Dale,
Townsend Raymond R.,
Cohen Debbie L.
Publication year - 2009
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2009.00120.x
Subject(s) - medicine , primary aldosteronism , adrenalectomy , blood pressure , creatinine , retrospective cohort study , family history , secondary hypertension , surgery
Adrenal venous sampling (AVS) remains controversial in the management of primary aldosteronism. Retrospective chart review was conducted at the Hospital of the University of Pennsylvania from July 2001 to September 2007. A total of 113 patients underwent AVS, 16 patients were excluded as records were unavailable. Among 97 remaining patients, 61 had unilateral disease and 57 underwent unilateral adrenalectomy. Blood pressure (BP) improved significantly with less antihypertensive medication requirement. Among those with different BP responses to adrenalectomy (cure, improvement, or no change), a higher number of preoperative antihypertensive medications was associated with persistent hypertension ( P = .03). There were no significant differences in age ( P = .14), duration of hypertension ( P = .60), family history of hypertension ( P = .68), or serum creatinine ( P = .34). When AVS shows lateralization, age, duration of hypertension, family history, or renal dysfunction did not predict BP response to adrenalectomy. Results suggest that these factors should not preclude AVS and subsequent adrenalectomy. Further studies are indicated to confirm these findings.