Improvement in quality of life and psychological symptoms after treatment for primary aldosteronism: Asian Cohort Study

• Published in: Endocrine Connections 2021-08, Vol.10 (8), p.834-844
• Main Authors: Tan, Yen Kheng, Kwan, Yu Heng, Teo, David Choon Liang, Velema, Marieke, Deinum, Jaap, Tan, Pei Ting, Zhang, Meifen, Khoo, Joan Joo Ching, Loh, Wann Jia, Gani, Linsey, King, Thomas F J, Tan, Eberta Jun Hui, Soh, Shui Boon, Au, Vanessa Shu Chuan, Tay, Tunn Lin, Dacay, Lily Mae Quevedo, Ng, Keng Sin, Wong, Kang Min, Wong, Andrew Siang Yih, Ng, Foo Cheong, Aw, Tar Choon, Chan, Yvonne Hui Bin, Tong, Khim Leng, Lee, Sheldon Shao Guang, Chai, Siang Chew, Puar, Troy Hai Kiat
• Format: Article
• Language: English
• Subjects: adrenalectomy; depression; hyperaldosteronism; mineralocorticoid receptor antagonists; quality of life; treatment outcome
• ISSN: 2049-3614; 2049-3614
• DOI: 10.1530/EC-21-0125

Background In addition to increased cardiovascular risk, patients with primary aldosteronism (PA) also suffer from impaired health-related quality of life (HRQoL) and psychological symptoms. We assessed for changes in HRQoL and depressive symptoms in a cohort of Asian patients with PA, after surgical and medical therapy. Methods Thirty-four patients with PA were prospectively recruited and completed questionnaires from 2017 to 2020. HRQoL was assessed using RAND-36 and EQ-5D-3L, and depressive symptoms were assessed using Beck Depression Inventory (BDI-II) at baseline, 6 months, and 1 year post-treatment. Results At 1 year post-treatment, significant improvement was observed in both physical and mental summative scores of RAND-36, +3.65, P = 0.023, and +3.41, P = 0.033, respectively, as well as four subscale domains (physical functioning, bodily pain, role emotional, and mental health). Significant improvement was also seen in EQ-5D dimension of anxiety/depression at 1 year post-treatment. Patients treated with surgery (n = 21) had significant improvement in EQ-5D index score post-treatment and better EQ-5D outcomes compared to the medical group (n = 13) at 1 year post-treatment. 37.9, 41.6 and 58.6% of patients had symptoms in the cognitive, affective and somatic domains of BDI-II, respectively. There was a significant improvement in the affective domain of BDI-II at 1 year post-treatment. Conclusion Both surgical and medical therapy improve HRQoL and psychological symptoms in patients with PA, with surgery providing better outcomes. This highlights the importance of early diagnosis, accurate subtyping and appropriate treatment of PA.