Clinical Study Of The Treatment Of Hypertension With Adrenal Diseases After Adrenalectomy

Background:As we all know,the prevalence of hypertension in China is still growing,every 10 adults there are two of them suffering from high blood pressure.It is estimated that the national current is at least 200 million hypertensive patients.Among them,secondary hypertension is a clear cause of hypertension,when the cause was found and effectively remove or control the cause,the symptoms hypertension can be cured or significantly alleviated;secondary hypertension in hypertensive population accounting for about 5%-10%.However,with the retrospective study of local areas in recent years it is found that the incidence of secondary hypertension in 10.9%-39.3%,the proportion is much higher than 10%,although the local data is not universal,but also reflects the Secondary hypertension is still to be improved,and China's high base of patients with hypertension,should cause full attention.Adrenal disease is one of the common causes of secondary hypertension.Although the incidence of secondary hypertension due to adrenal disease is not confirmed by a consistent,large-scale clinical study,but small studies have found a high proportion of secondary adrenal diseases in secondary hypertensionObjective:Hypertension is one of the most commonly disease which about 200 million people suffer from in our country.As it is known to all,long-term hypertension easily lead to the damage of heart,brain,kidney and other target organ,which is seriously endangering health.Among numerous cause,the morbidity of secondary hypertension specifically adrenal diseases proved to be a kind of significant surgical treatment rises yearly.Therefore,identifying the etiology of hypertension to guide treatment and improve prognosis is significant.Method:Characteristics from 181 patients with hypertension and adrenal disease,treated with adrenalectomy between 2012 and 2016 were collected from our center.Factors affecting complete hypertension cure were assessed using logistic regression.Results:At the end of follow-up,107(59.1%)patients were completely cured,whereas 67(37.0%)patients were improved,and 7(3.9%)patients remain refractory.Age(p = 0.028),>2 antihypertensive agents(p<0.001),duration of hypertension(p<0.001),duration of hypokalemia(p = 0.038),systolic blood pressure(p = 0.040),and level of plasma aldosterone(p<0.001)were associated with hypertension outcomes in univariate analysis.However,multivariate logistic regression analysis showed that only antihypertensive agents>2(OR = 0.602,95%CI 0.410-0,783,p = 0.001)duration of hypertension>6 years(OR = 0.496,95%CI 0.323-0.762;p = 0.001)and level of plasma aldosterone>35 ng/dl(OR = 0.503,95%CI 0.326-0.776,p = 0.001)were the significantly independent factors affecting complete hypertension cure.Conclusion:This is the largest series to show that only duration of hypertension and level of plasma aldosterone were the factors affecting complete hypertension cure after adrenalectomy for APA.This study highlights the importance of early diagnosis and early adrenalectomy.