Clinical presentation and surgical outcomes in primary aldosteronism differ by race

Background Primary aldosteronism (PA) is the most common cause of secondary hypertension; early diagnosis and intervention correlate with outcomes. We hypothesized that race may influence clinical presentation and outcomes. Methods We conducted a retrospective analysis of patients with PA (1997‐2017...

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Published in:Journal of surgical oncology 2020-03, Vol.121 (3), p.456-464
Main Authors: Gershuni, Victoria M., Ermer, Jae P., Kelz, Rachel R., Roses, Robert E., Cohen, Debbie L., Trerotola, Scott O., Fraker, Douglas L., Wachtel, Heather
Format: Article
Language:English
Subjects:
adrenal
Adrenalectomy - adverse effects
aldosteronoma
disparities
Endocrine disorders
Female
Follow-Up Studies
Humans
Hyperaldosteronism - pathology
Hyperaldosteronism - surgery
Hypertension
Hypertension - etiology
Male
Medical diagnosis
Middle Aged
Postoperative Complications
primary aldosteronism
Prognosis
race
Racial differences
Racial Groups - statistics & numerical data
Retrospective Studies
Surgical outcomes
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Summary:Background Primary aldosteronism (PA) is the most common cause of secondary hypertension; early diagnosis and intervention correlate with outcomes. We hypothesized that race may influence clinical presentation and outcomes. Methods We conducted a retrospective analysis of patients with PA (1997‐2017) who underwent adrenal vein sampling (AVS). Patients were classified by self‐reported race as black or non‐black. Improvement was defined as postoperative decrease in mean arterial pressure (MAP), antihypertensive medications (AHM), or both. Results Among patients undergoing AVS (n = 443), 287 underwent adrenalectomy. Black patients (28.2%) had higher body mass index (33.9 vs 31.8 kg/m2; P = .01), longer median duration of hypertension (12 vs 10 years; P = .003), higher modified Elixhauser comorbidity index (2 vs 1; P = .004), and lower median income ($47 134 vs $78 280; P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25806