Abstract:

Background: Treatment resistant hypertension (trHTN) is not a rare clinical problem faced by many clinicians. Laparoscopic adrenalectomy is demonstrated effective to control blood pressure in most functional adrenal disorders and some non-functional adrenal tumors. The effect of adrenalectomy in trHTN patients would be instructing, whereas rarely reported. In this paper, we aimed to summarize the BP impact of adrenalectomy in trHTN patients.

Methods: Patients diagnosed with trHTN of undetermined origin and proceed with unilateral adrenlectomy from 2011 to 2017 in Shandong Provincial Hospital were consecutively enrolled in this study. Electronic medical reports reviewing and long-term telephone interview follow-up was conducted for baseline and prognosis information collecting.

Results: At the end of averagely 36.2 months follow-up, trHTN obtained curation in 27 (25%) and amelioration in 68(62%) in total 109 patients. The average numbers of anti-hypertensive medications taken reduced from 4.21 to 1.21 (P≤0.001), accompanied with 5mmHg reduction in systolic blood pressure (P=0.019). “Imaging definite lateralization” and hypokalemia were found two strongest predictors for postoperative hypertension remission (χ²=28.032, P≤0.001).

Conclusions: Unilateral adrenalectomy represents an efficacious and safe strategy for blood pressure control in trHTN patients of undetermined origin.