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Drug-resistant hypertension in primary aldosteronism patients undergoing adrenal vein sampling: the AVIS-2-RH study
GP. Rossi, G. Rossitto, L. Amar, M. Azizi, A. Riester, M. Reincke, C. Degenhart, J. Widimsky, M. Naruse, J. Deinum, L. Schultze Kool, T. Kocjan, A. Negro, E. Rossi, G. Kline, A. Tanabe, F. Satoh, LC. Rump, O. Vonend, HS. Willenberg, PJ. Fuller,...
Language English Country Great Britain
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Adrenalectomy adverse effects methods MeSH
- Hyperaldosteronism * diagnosis surgery MeSH
- Hypertension * diagnosis drug therapy epidemiology MeSH
- Humans MeSH
- Adolescent MeSH
- Adrenal Glands blood supply surgery MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
AIMS: We aimed at determining the rate of drug-resistant arterial hypertension in patients with an unambiguous diagnosis of primary aldosteronism (PA). Moreover, we sought for investigating the diagnostic performance of adrenal vein sampling (AVS), and the effect of adrenalectomy on blood pressure (BP) and prior treatment resistance in PA patients subtyped by AVS in major referral centres. METHODS AND RESULTS: The Adrenal Vein Sampling International Study-2 (AVIS-2) was a multicentre international study that recruited consecutive PA patients submitted to AVS, according to current guidelines, during 15 years. The patients were over 18 years old with arterial hypertension and had an unambiguous diagnosis of PA. The rate of resistant hypertension was assessed at baseline and after adrenalectomy using the American Heart Association (AHA) 2018 definition. Information on presence or absence of resistant hypertension was available in 89% of the 1625 enrolled PA patients. Based on the AHA 2018 criteria, resistant hypertension was found in 20% of patients, of which about two-thirds (14%) were men and one-third (6%) women (χ2 = 17.1, P < 1*10-4) with a higher rate of RH in men than in women (23% vs. 15% P < 1*10-4). Of the 292 patients with resistant hypertension, 98 (34%) underwent unilateral AVS-guided adrenalectomy, which resolved BP resistance to antihypertensive treatment in all. CONCLUSIONS: (i) Resistant hypertension is a common presentation in patients seeking surgical cure of PA; (ii) AVS is key for the optimal management of patients with PA due to resistant hypertension; and (iii) AVS-guided adrenalectomy allowed resolution of treatment-resistant hypertension.
3rd Department of Medicine Charles University Prague General Hospital Prague Czech Republic
AP HP Hôpital Européen Georges Pompidou Hypertension Department and DMU CARTE F 75015 Paris France
Department of Endocrinology University of St Petersburg Russia
Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan
Department of Internal Medicine Radboud University Nijmegen Nijmegen Netherlands
Department of Medicine Monash University Clayton Victoria Australia
Department of Nephrology Endocrinology and Vascular Medicine Tohoku University Hospital Sendai Japan
Department of Nephrology Medical Faculty Heinrich Heine University Düsseldorf Germany
Endocrinology in Charlottenburg Berlin Germany
Faculty of Medicine University of Ljubljana Vrazov trg 2 1000 Ljubljana Slovenia
Institute of Cardiovascular and Medical Sciences University of Glasgow Glasgow UK
Institute of Clinical Endocrinology Tokyo Women's Medical University Tokyo Japan
Medizinische Klinik und Poliklinik 4 Klinikum der Universität München LMU München München Germany
Université de Paris INSERM CIC1418 and UMR 970 F 75015 Paris France
University of Calgary Foothills Medical Centre Calgary Canada
References provided by Crossref.org
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