PERSISTENT HYPERTENSION AFTER SUCCESSFUL ADRENAL OPERATION

Background. UP to 80% of patients with adrenocortical tumors comprisin g Conn's or Cushing's syndrome and patients with pheochromocytomas suf fer from hypertension. Its implications in cardiovascular disease and its impact on quality of life make it the most important aim in therap eutic efforts. The aim Of our study was to assess the long-term result s in postoperative blood pressure after adrenalectomy and to evaluate potential risk factors for persistent hypertension. Methods. Forty fou r patients with adrenal hypertension operated on between April 1986 an d April 1991 underwent follow-up consisting of exact history, hormonal analysis, and adrenal imaging. Results. Forty three patients were ree xamined, which showed 11 patients (26%) with hypertension at dismissal from hospital and 17 patients (40%) with hypertension after a median of 2 years. Except for two recurrent tumors in adrenocortical carcinom a all patients were surgically cured. Antihypertensive medication coul d be reduced in 13 of 17 patients with persistent hypertension. Persis tent hypertension did not correlate with the degree of preoperative bl ood pressure elevation, age, and gender, but it did correlate strongly with history of hypertension. Patients with normal blood pressure lev el after operation had a mean history of 5.7 years versus 11.5 years i n patients with persistent hypertension (p < 0.03). Conclusions. The s uccess of surgical treatment for adrenal hypertension strongly depends on early diagnosis and surgical intervention.