ECE2016 Eposter Presentations Adrenal cortex (to include Cushing's) (85 abstracts)
Primary hyperaldosteronism: clinical and therapeutic approach of a center
Diana Martins , Carolina Moreno , Carla Baptista , Isabel Paiva , Daniela Guelho , Nuno Vicente , Luís Cardoso , Diana Oliveira , Adriana Lages , Mara Ventura & Francisco Carrilho
Endocrinology, Diabetes and Metabolism Department of Coimbra University Hospital Centre, Coimbra, Portugal.
Introduction: Primary hyperaldosteronism (HAP) is the main cause of secondary hypertension, with a prevalence estimated between 6 and 20% in resistant hypertension. Clinical suspicion is critical, especially if aldosterone-to-renin ratio (ARR) >25, however the diagnosis is dependent on confirmatory evidence, including aldosterone suppression tests.
Methods: Retrospective evaluation of 44 patients with suspected PAH, identified between 2010 and 2015 at a single center.
Results: Sixteen of 44 patients had hormonal findings consistent with the diagnosis: nine men, seven women; mean age 60.50±9.75 years. Median time of hypertension: 9.00 years.
Fourteen patients had adrenal masses on CT evaluation (dimensions 1.44±0.88 cm): 12 with unilateral nodules and two bilateral.
Aldosterone-to-renin ratio >25 in 14 patients and two patients presented with ARR >20, associated to aldosterone >10 ng/ml with suppressed renin. All of them with positive saline infusion test (SIT).
Eight patients undergone laparoscopic adrenalectomy; anatomopathological result: adrenal cortical adenoma in seven patients and adrenal hyperplasia in one. Of these, four kept medical therapy with reduction of antihypertensive drugs.
Eight patients maintained medical therapy due to bilateral lesions, absence of surgical conditions or intervention refusal.
Follow-up at 6 months: significant reduction of systolic BP (143.00±17.15 vs 133.00±13.37 mmHg; P=0.008) and the number of required antihypertensive drugs (2.00±0.85 vs 0.50±1.26; P=0.004); systolic BP was also significantly lower on surgically treated patients (120±13.22 vs 140±7.36 mmHg; P=0.021).
Conclusions: On follow-up at 6 months, it was found a significant overall reduction in the levels of systolic blood pressure and the number of antihypertensive drugs.
Surgical treatment produced a more significant reduction in the levels of systolic BP compared with medical treatment alone. The reduction of serum aldosterone levels was also higher in the group undergoing surgery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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