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Zhao J, Dai J, Zhou W, Wang H, Rui W, He W, Zhu Z, Zhu Y, Xu D, Sun F. Predictors of hypertension urgency in primary aldosteronism patients during the first 24 hours after surgery. Oncotarget 2017; 8:93251-93257. [PMID: 29190995 PMCID: PMC5696261 DOI: 10.18632/oncotarget.21632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/21/2017] [Indexed: 11/25/2022] Open
Abstract
Study about blood pressure variation in the first 24 hours post-operation is limited in patients with adrenal aldosterone-producing adenoma. We aim to evaluate the potential predictors for postoperative hypertension urgency during the first 24 hours after laparoscopic adrenalectomy in patients with aldosterone-producing adenoma. Clinical data of 177 patients with aldosterone-producing adenoma were retrospectively collected from January 2009 to December 2015 and the potential factors that may influence postoperative blood pressure during the first 24 hours after surgery were analyzed. The factors included gender, age, body mass index, preoperative maximum systolic blood pressure, number of antihypertensive medicines, preoperative spironolactone treatment, duration of hypertension, surgical method and approach, adenoma diameter, preoperative proteinuria, estimated glomerular filtration rate, serum potassium and serum aldosterone. Univariate and multivariate regression analyses were used to evaluate the relationship between the above variables and postoperative hypertension urgency. We found that the proportion of patients with a higher systolic blood pressure ≥ 160 mmHg and ≥ 180 mmHg were significantly increased post-operation (both p < 0.001). In multivariate analysis, the maximum systolic blood pressure was an independent predictor of postoperative hypertension urgency, and the cut-off point was 157 mmHg with the sensitivity of 66% and specificity of 82%. Multivariable analysis also showed that preoperative maximum systolic blood pressure and number of antihypertensive medicines were independent risk factors for higher postoperative systolic blood pressure. This study was derived from a high volume adrenal tumor center, and these data may provide a potential tool to guide preoperative counseling.
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Affiliation(s)
- Juping Zhao
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Jun Dai
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Wenlong Zhou
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Haofei Wang
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Wenbin Rui
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Wei He
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Zhe Zhu
- Department of Medicine, Division of Regenerative Medicine, University of California, San Diego, School of Medicine, La Jolla, CA, 92037 USA.,Department of Stem Cell Biology and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, 44195 USA
| | - Yu Zhu
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Danfeng Xu
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
| | - Fukang Sun
- Shanghai JiaoTong University School of Medicine, Ruijin Hospital, Department of Urology, Shanghai, 200025 China
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Franco Palacios CR, Goyal P, Thompson AM, Deschaine B. Systolic blood pressure values might further risk-stratify the adverse outcomes of LVH in older patients with chronic kidney disease. Clin Hypertens 2016; 22:21. [PMID: 27895935 PMCID: PMC5120495 DOI: 10.1186/s40885-016-0056-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022] Open
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