Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Dec 1;40(12):2486-2493.
doi: 10.1097/HJH.0000000000003284. Epub 2022 Aug 23.

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Marta Araujo-Castro  1   2 , Miguel Paja Fano  3 , Marga González Boillos  4 , Begoña Pla Peris  4 , Eider Pascual-Corrales  1 , Ana María García Cano  5 , Paola Parra Ramírez  6 , Patricia Martín Rojas-Marcos  6 , Jorge Gabriel Ruiz-Sanchez  7 , Almudena Vicente Delgado  8 , Emilia Gómez Hoyos  9 , Rui Ferreira  10 , Iñigo García Sanz  11 , Mònica Recasens Sala  12 , Rebeca Barahona San Millan  12 , María José Picón César  13 , Patricia Díaz Guardiola  14 , Juan Jesús García González  15 , Carolina M Perdomo  16 , Laura Manjón Miguélez  17 , Rogelio García Centeno  18 , Juan Carlos Percovich  18 , Ángel Rebollo Román  19 , Paola Gracia Gimeno  20 , Cristina Robles Lázaro  21 , Manuel Morales-Ruiz  22 , Felicia A Hanzu  23
Affiliations
Multicenter Study

Predictive model of hypertension resolution after adrenalectomy in primary aldosteronism: the SPAIN-ALDO score

Marta Araujo-Castro et al. J Hypertens. .

Abstract

Purpose: To develop a predictive model of hypertension resolution after adrenalectomy in patients with primary aldosteronism (PA), based on their presurgical characteristics.

Methods: A retrospective multicenter study of PA patients in follow-up in 20 Spanish tertiary hospitals between 2018 and 2021 was performed (SPAIN-ALDO Register). Clinical response postadrenalectomy was classified according to the primary aldosteronism surgical outcome (PASO) consensus criteria. The predictive model was developed using a multivariate logistic regression model with the estimation of all possible equations.

Results: A total of 146 patients (54.8% females; mean age of 51.5 ± 10.9 years) with PA who underwent unilateral adrenalectomy were included. After a mean follow-up of 29.1 ± 30.43 months after surgery, hypertension cure was obtained in 37.7% ( n = 55) of the patients. The predictive model with the highest diagnostic accuracy to predict hypertension cure combined the variables female sex, use of two or fewer antihypertensive medications, hypertension grade 1, without type 2 diabetes and nonobesity. The area under the receiver operating characteristic curve of this model was 0.841 [0.769-0.914]. Based on this model, the group of patients with a higher probability of cure (80.4%) were those without type 2 diabetes, BMI <30 kg/m 2 , female sex, hypertension grade 1 and who use two or fewer antihypertensives. Our predictive model offered a slightly higher diagnostic accuracy than Wachtel's (area under the curve [AUC]: 0.809), Utsumi's (AUC: 0.804) and Zarnegar's (AUC: 0.796) models and was similar than the Burello's (AUC: 0.833) model.

Conclusion: Female sex, use of two or fewer antihypertensive medications, hypertension grade 1, no type 2 diabetes and nonobesity may predict hypertension cure after adrenalectomy in patients with PA. Our score provides a potential tool to guide preoperative patient counseling.

PubMed Disclaimer

References

    1. Douma S, Petidis K, Doumas M, Papaefthimiou P, Triantafyllou A, Kartali N, et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet 2008; 371:1921–1926.
    1. Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol 2006; 48:2293–2300.
    1. Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016; 101:1889–1916.
    1. Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, et al. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol 2017; 5:689–699.
    1. Burrello J, Burrello A, Stowasser M, Nishikawa T, Quinkler M, Prejbisz A, et al. The primary aldosteronism surgical outcome score for the prediction of clinical outcomes after adrenalectomy for unilateral primary aldosteronism. Ann Surg 2020; 272:1125–1132.

Publication types

Substances

LinkOut - more resources