Surgical Approach to Endocrine Hypertension in Patients with Adrenal Disorders

Endocrinol Metab Clin North Am. 2019 Dec;48(4):875-885. doi: 10.1016/j.ecl.2019.08.014. Epub 2019 Sep 25.

Abstract

Increased hormonal secretion of aldosterone, cortisol, or catecholamines from an adrenal gland can produce a variety of undesirable symptoms, including hypertension, which may be the initial presenting symptom. Consequences of secondary hypertension can result in potential cardiovascular and cerebrovascular complications at higher rates than in those with essential hypertension. Once a biochemical diagnosis is confirmed, targeted pharmacotherapy can be initiated to improve hypertension and may be corrected with surgical intervention. Adrenalectomy can be curative and can reverse the risk of cardiovascular sequelae once blood pressure control is achieved. This article discusses perioperative and operative considerations of adrenal causes of hypertension.

Keywords: Adrenalectomy; Cushing syndrome; Endocrine hypertension; Hyperaldosteronism; Hypercortisolism; Pheochromocytoma; Secondary hypertension.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy*
  • Adrenocortical Hyperfunction / complications
  • Adrenocortical Hyperfunction / surgery*
  • Cushing Syndrome / complications
  • Cushing Syndrome / surgery*
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / surgery*
  • Hypertension / etiology
  • Hypertension / surgery*
  • Pheochromocytoma / complications
  • Pheochromocytoma / surgery*