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<p>Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9–15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery. This study developed and validated a novel predictive scoring model for persistent hypertension following adrenalectomy based on 363 patients from a 25-year single-center experience. Persistent hypertension occurred in 59.5% of patients postoperatively. Multivariable analysis identified five independent predictors: age ≥ 50 years, dyslipidemia, BMI ≥ 25&#xa0;kg/m<sup>2</sup>, use of ≥ 3 antihypertensive medications, and hypertension duration ≥ 5 years. The model demonstrated excellent discriminative ability with area under the curve of 0.81 in internal validation and 0.72 in external validation. Predictive risk scores were categorized into low-risk (0–1), intermediate-risk (2–3), and high-risk (4–5) groups, with persistent hypertension rates of 23.5%, 72.1%, and 90.6%, respectively. This practical scoring system enables improved preoperative counseling and individualized management planning using readily available clinical parameters.</p>

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Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月29日

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  • Kawintharat Harirugsakul,
  • Swiss Suharitdumrong,
  • Kamol Panumatrassamee,
  • Supoj Ratchanon,
  • Manint Usawachintachit,
  • Dutsadee Sowanthip,
  • Pea Pobpan,
  • Gantapong Sainont,
  • Apirak Santingamkun

摘要

Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9–15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery. This study developed and validated a novel predictive scoring model for persistent hypertension following adrenalectomy based on 363 patients from a 25-year single-center experience. Persistent hypertension occurred in 59.5% of patients postoperatively. Multivariable analysis identified five independent predictors: age ≥ 50 years, dyslipidemia, BMI ≥ 25 kg/m2, use of ≥ 3 antihypertensive medications, and hypertension duration ≥ 5 years. The model demonstrated excellent discriminative ability with area under the curve of 0.81 in internal validation and 0.72 in external validation. Predictive risk scores were categorized into low-risk (0–1), intermediate-risk (2–3), and high-risk (4–5) groups, with persistent hypertension rates of 23.5%, 72.1%, and 90.6%, respectively. This practical scoring system enables improved preoperative counseling and individualized management planning using readily available clinical parameters.