ECE2022 Eposter Presentations Adrenal and Cardiovascular Endocrinology (131 abstracts)
Arterial hypertension in elderly patients carrying adrenal incidentaloma: epidemiological, clinical and therapeutic features
Faten Haj Kacem Akid 1 , Abdelmouhaymen Missaoui 1 , Mariem Belhoul 2 , Wafa Belabed 1 , Dhoha Ben Salah 1 , Mnif Fatma 1 , Nadia Charfi 1 , Mouna Mnif 1 , Nabila Rekik Majdoub 1 , Mouna Elleuch 1 & Mohamed Abid 1
1Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia; 2Faculty of Medicine of Sfax, Depatment of Family Medicine, Tunisia.
Background and Aims: Arterial hypertension (AH) is one of the most common comorbidities in the elderly. The association of adrenal incidentaloma (AI) with AH in older patients may influence the clinical and therapeutic outcomes of the latter condition. In the current study, we aimed to assess the prevalence of AH and its clinical and therapeutic features in geriatric patients bearing AI.
Patients and Method: We conducted a retrospective descriptive study including 69 patients aged 65 years and above diagnosed with AI. All patients have undergone clinical examination, adrenal CT, and biochemical workup at the Endocrinology Department of Hedi Chaker University Hospital, Sfax, Tunisia, from 2011 to 2020.
Results: The mean age at diagnosis was 71.4±4.2 years, with a female predominance (57.5%). Hypertension was the most common metabolic disorder encountered in 77.5% of aged patients carrying AI. The mean systolic blood pressure was 132 mmHg (extremes=100–180). The mean diastolic blood pressure was 75 mmHg (extremes=50–120). AH was newly diagnosed in 10% of cases thanks to a 24-hour ambulatory blood pressure monitoring during the AI clinical assessment. For the patients already diagnosed with AH, the average duration of hypertension was 8.9±7.2 years. Most elderly patients with AI had stage I high blood pressure (87.1%) at diagnosis. Stage II (9.7%) and stage III (3.2%) AH were less frequently encountered. Antihypertensive monotherapy was proposed for 51.9% of patients. Antihypertensive bitherapy (29.6%) or tritherapy (11.1%), quadritherapy (3.7%) were less prescribed. Target organ damage related to AH was observed in 37%, mainly renal (29.4%) and neurological (22.2%) complications. Primary hypertension was the most common form in 70% of cases. Secondary AH was diagnosed in 30% of aged patients having AI due to autonomous cortisol secretion (32.5%), primary hyperaldosteronism (25%), or secondary hyperaldosteronism (21.8%). One senior had a secreting pheochromocytoma. Bilateral AI (92.3%) is subsequently more associated with AH in aged patients than unilateral AI (57.7%) (P=0.027). We did not establish any significant correlation between the AI size and the severity of AH.
Conclusion: Although the prevalence of AH increases with aging, secondary hypertension must be excluded in hypertensive aged patients with AI, mainly autonomous cortisol hypersecretion and pheochromocytoma. The studied population shared the same clinical and therapeutic features as the general hypertensive population. Despite its hormonal profile, bilateral AI is a significant predictive factor of the onset of AH in the elderly.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more