Adrenalectomy; Status, Cardiovascular Morbidity, Chronic Renal Disease, Hypokalemia, Mineralocorticoid Antagonists [Aldosterone Antagonists] Causing Adverse Effects in Therapeutic Use, Mineralocorticoid Excess, Primary Aldosteronism, Primary Aldosteronism Due to Adrenal Hyperplasia (Bilateral), Primary Aldosteronism Due to Aldosterone Producing Adenoma
Conditions
Brief summary
Majority of patients with hypertension have primary hypertension (without an underlying cause). Primary aldosteronism (PA) is the most common cause of secondary hypertension, and can be found in 5-10% of patients locally. PA is caused by excessive release of a hormone (aldosterone) from the adrenal glands, which can be unilateral (one gland) or bilateral (both glands). It has been shown that excess aldosterone has other harmful effects in addition to hypertension, such as directly affecting the heart, blood vessels, kidneys, leading to increased cardiovascular morbidity and mortality. This is supported by studies showing reversal of these effects after treatment for PA. The investigators aim to assess the long-term cardiovascular, and renal outcomes of patients with PA, compared to patients with essential hypertension.
Interventions
PROCEDUREUnilateral adrenalectomy in patients with unilateral disease
Unilateral adrenalectomy in patients with unilateral disease
Sponsors
Singapore General Hospital
Changi General Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
14 Years to 100 Years
Inclusion criteria
* Patients with suspected primary aldosteronism
Exclusion criteria
* Nil
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in systolic blood pressure before and after treatment | six months after treatment | change in systolic blood pressure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change in systolic blood pressure before and after treatment | through study completion, an average of 5 years | change in systolic blood pressure |
| cardiovascular outcome | through study completion, an average of 5 years | incidence of new cardiovascular events including acute myocardial infarction, revascularisation percutaneously, coronary artery bypass graft, stroke, admission for congestive cardiac failure, atrial fibrillation |
| chronic kidney disease | through study completion, an average of 5 years | incidence of worsening chronic kidney disease, decline of glomerular filtration rate by 15ml/min from at least 60m/min |
| change in diastolic blood pressure before and after treatment | six months after treatment | change in diastolic blood pressure |
| variables that predict unilateral disease | through study completion, an average of 5 years | Identify variables that are more common in patients with unilateral disease |
| variables that predict blood pressure response | through study completion, an average of 5 years | Identify variables that are more common in patients with positive blood pressure response |
| Renal Progression | through study completion, an average of 5 years | rate of decline of glomerular filtration rate |
Countries
Singapore
Contacts
Primary ContactTroy Puar, MRCP
Outcome results
None listed