Original CommunicationHigh predictive accuracy of Aldosteronoma Resolution Score in Japanese patients with aldosterone-producing adenoma
Section snippets
Patient selection
We surveyed retrospectively the clinical variables associated with complete resolution of hypertension among patients seen at Chiba University Hospital. Between June 1997 and July 2010, 102 patients with the diagnosis of APA underwent unilateral adrenalectomy at our institution. Because of missing or inappropriate data or patient follow-up for <6 months, 11 patients were excluded from additional analysis. The remaining 91 patients were analyzed. The criteria used to establish the diagnosis of
Results
Complete resolution of hypertension was confirmed postoperatively in 45% of patients at the 6-month follow-up. Better control of hypertension—defined as a decrease in BP or fewer antihypertension medications taken at 6 months postadrenalectomy—was achieved in 98% of the patients with persistent hypertension.
Seventy-three patients had hypokalemia preoperatively. Resolution of hypokalemia was achieved in all patients after resection. We defined the postoperative normalization of plasma
Discussion
The primary objectives of adrenalectomy in patients with APA are correction of the biochemical features of hyperaldosteronism and improvement, if not complete resolution, of hypertension.13 In our study, operative management led successfully to the normalization of plasma levels of aldosterone in 99% of patients. Postoperative plasma levels of aldosterone were not significantly linked with hypertension outcome. Therefore, hypertension outcome was not thought to be affected by postoperative
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Cited by (45)
Long-term outcome success after operative treatment for primary aldosteronism
2021, Surgery (United States)Citation Excerpt :Although adrenalectomy has been considered the standard treatment for the biochemical and clinical alterations seen in PA, the biochemical resolution of PA is not always concordant with the resolution of its clinical manifestations.7 More recent studies have been performed to predict the clinical outcomes of patients with APA after adrenalectomy.8–10 The previously described Aldosterone Resolution Score (ARS) identifies 4 objective factors that predict the resolution of hypertension in patients with APA after adrenalectomy, which includes 2 or fewer antihypertensive medications, body mass index (BMI) ≤25 kg/m2, a duration of hypertension ≤6 years, and female sex.7
Hypertension resolution after adrenalectomy for primary hyperaldosteronism: Which is the best predictive model?
2021, Surgery (United States)Citation Excerpt :The ARS has been assessed for generalizability and accuracy in the literature.15 It has been demonstrated to have moderate-to-good predictive validity within North America and in Japan,18,19 although it is potentially less applicable to European and Australian patients.18,20,21 The Utsumi et al16 nomogram and the Wachtel et al17 scoring system have not been similarly tested for external validity across alternate patient cohorts.
The 2020 Italian Society of Arterial Hypertension (SIIA) practical guidelines for the management of primary aldosteronism
2020, International Journal of Cardiology: HypertensionAdrenal Incidentaloma
2018, Abernathy's Surgical Secrets: Seventh Edition