医学
原发性醛固酮增多症
肾上腺切除术
血压
醛固酮增多症
内科学
动脉硬化
泌尿科
醛固酮
心脏病学
脉冲波速
外科
作者
Zheng-Wei Chen,Che‐Wei Liao,Chien‐Ting Pan,Cheng‐Hsuan Tsai,Yuan‐Jen Chang,Chin‐Chen Chang,Bo-Ching Lee,Yu‐Wei Chiu,Wei‐Chieh Huang,Tai‐Shuan Lai,Ching‐Chu Lu,Jeff S Chueh,Vin‐Cent Wu,Chi‐Sheng Hung,Yen‐Hung Lin
标识
DOI:10.1097/hjh.0000000000003631
摘要
Objective: Hyperaldosteronism has adverse effects on cardiovascular structure and function. Laparoscopic adrenalectomy is the gold standard for patients with unilateral primary aldosteronism. For unilateral primary aldosteronism patients unable or unwilling to undergo surgery, the effects of mineralocorticoid receptor antagonists (MRAs) on the reversibility of arterial stiffness and other clinical data remain unclear. We aimed to compare the reversibility of arterial stiffness using pulse wave velocity (PWV) and other clinical parameters between surgically and medically treated unilateral primary aldosteronism patients. Methods: We prospectively enrolled 306 unilateral primary aldosteronism patients, of whom 247 received adrenalectomy and 59 received medical treatment with MRAs. Detailed medical history, basic biochemistry and PWV data were collected in both groups before treatment and 1 year after treatment. After propensity score matching (PSM) for age, sex, SBP and DBPs, 149 patients receiving adrenalectomy and 54 patients receiving MRAs were included for further analysis. Results: After PSM, the patients receiving adrenalectomy had a greater reduction in blood pressure, increase in serum potassium, and change in PWV (ΔPWV, −53 ± 113 vs. −10 ± 140 cm/s, P = 0.028) than those receiving MRAs 1 year after treatment. Multivariable regression analysis further identified that surgery (compared with MRA treatment), baseline PWV, baseline DBP, the change in DBP and the use of diuretics were independently correlated with ΔPWV. Conclusion: Adrenalectomy is superior to MRA treatment with regards to vascular remodeling when treating unilateral primary aldosteronism patients.
科研通智能强力驱动
Strongly Powered by AbleSci AI