World Journal of Endocrine Surgery

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VOLUME 13 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Hypertension Cure and Reducing Pill Burden after Adrenalectomy for Endocrine Hypertension of Adrenal Origin: A Comparative Study from an Asian and UK Cohort

Ciaran Durand, Titus C Vasciuc, Chia H Tai, Raluca Orpean, Fiona Eatock, Mehak Mahipal, Tan W Boon, Kee Y Ngiam, Rajeev Parameswaran

Keywords : Adrenal, Adrenalectomy, Aldosterone-producing adenoma, Cushing\'s adenoma, Hypertension, Pheochromocytoma

Citation Information : Durand C, Vasciuc TC, Tai CH, Orpean R, Eatock F, Mahipal M, Boon TW, Ngiam KY, Parameswaran R. Hypertension Cure and Reducing Pill Burden after Adrenalectomy for Endocrine Hypertension of Adrenal Origin: A Comparative Study from an Asian and UK Cohort. World J Endoc Surg 2021; 13 (1):9-15.

DOI: 10.5005/jp-journals-10002-1314

License: CC BY-NC 4.0

Published Online: 20-11-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: The cure rate of endocrine hypertension following adrenalectomy is heterogeneous. Our aim of the study was to investigate the etiology and cure rate of endocrine hypertension between an Asian and UK cohort. Materials and methods: This is a retrospective study of patients who underwent adrenalectomy from two tertiary centers in Singapore (cohort I) and the UK (cohort II) for endocrine hypertension. Demographic, clinical details, blood pressure data, and cure rates of hypertension were collected and analyzed. Results: Cohort I included 115 patients (59F:56M), the mean age of 50.05 (SD 12.82), and cohort II had 128 patients (65F:63M), the mean age of 52.88 (SD 14.45) during the study period. There was a higher incidence of Conn\'s adenoma in cohort I, with predominantly left-sided tumors and grade I and II hypertension at presentation (p = 0.001). In contrast, cohort II had pheochromocytoma (PCC) as the most frequent diagnosis, right-sided tumors, and grade II and III hypertension (p = 0.001). Significant differences in the mean pre-op systolic and diastolic BP and choice of antihypertensive medications between the two cohorts were noted (p = 0.001). The hypertension cure rates were similar (70 vs 69%) between the two cohorts. In patients where no cure was achieved, adrenalectomy resulted in a decrease in the pill burden (decreased number of classes and standard dose) in both the cohorts (p = 0.03). The complications rates and overall mortality were comparable between the cohorts. Conclusion: The etiology of adrenal hypertension is different between the East and the West. Adrenalectomy cured hypertension in the majority of the patient and reduced pill burden where no cure for hypertension was achieved.


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