Factors Associated with Resolution of Hypertension after Adrenalectomy in Patients with Primary Aldosteronism

Background: The aim of this study was to investigate the factors associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism. A secondary aim was to describe our use of the contralateral ratio in adrenal venous sampling (AVS) in the setting of suboptimal successful cannulation rates. Methods: A retrospective review of patients who underwent AVS followed by unilateral adrenalectomy for primary aldosteronism was performed. Results: Complete resolution of hypertension and hypokalemia was seen in 17 of 40 patients (42.5%), while a clinical improvement in hypertension was seen in 38 of 40 (95%). Shorter duration of hypertension, mean aldosteronoma resolution score (ARS), and a high ARS of 3 to 5 were associated with resolution of hypertension after adrenalectomy (P = 0 .02, P = 0 .02, and P = 0 .004, respectively). Of the individual components of ARS, only a duration of hypertension of years was associated with resolution of hypertension after adrenalectomy (P = 0.03). Conclusion: A shorter duration of hypertension was significantly associated with resolution of hypertension after adrenalectomy in patients with primary aldosteronism.