Risk factors associated with postoperative persistent hypertension in patients with primary aldosteronism

Surgery. 1992 Dec;112(6):987-93.


Background: Unilateral adrenalectomy was performed in 63 patients with primary aldosteronism. During a mean follow-up time of 4.1 years, none of the patients showed recurrence of hyperaldosteronism. However, 24 patients (38%) had persistent hypertension. The purpose of this study was to determine factors responsible for postoperative persistent hypertension.

Methods: A stepwise multivariate logistic regression analysis was performed to assess the combined predictive effects of the clinicopathologic variables.

Results: Age, sex, and pathologic findings were the best predictive factors of postoperative persistent hypertension. For a patient aged 50 years or more, the odds of persisting hypertension are 10.6:1, compared with those of a patient under 40 years of age. A male patient appears to have a greater chance of hypertension than a female patient; the odds ratio is 5.9:1. Persistent hypertension develops in patients with multiple adenomas or with an adenoma associated with macronodules more frequently than in those patients with a solitary adenoma; the odds ratio is 8.1.

Conclusions: This study suggests that early surgical intervention at a younger age results in a more favorable outcome for patients with primary aldosteronism. The presence of macronodules in association with an adenoma is a cautious predictor of persistent hypertension after adrenalectomy.

MeSH terms

  • Adrenalectomy*
  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Hyperaldosteronism / pathology
  • Hyperaldosteronism / surgery*
  • Hypertension / etiology*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Sex Factors