In this retrospective study, researchers analyzed 400 adults with hypertension caused by primary hyperaldosteronism. They discovered that obese patients had smaller aldosterone-producing tumors than their lower-BMI counterparts. However, despite their smaller size, these tumors appeared more aggressive and had higher hormonal activity.
Adrenalectomy resulted in similar blood pressure improvements regardless of BMI, suggesting that obesity does not compromise surgical outcomes. While these findings require further validation, they highlight an important phenotype that endocrinologists, radiologists, and surgeons should recognize when evaluating and managing these patients.
Surgery, Retrospective
September 2019
Background
Obese patients may have unrecognized primary aldosteronism due to high rates of concomitant hypertension. We hypothesized that obesity impacts the diagnosis and management of patients with primary aldosteronism.
Methods
We conducted a retrospective analysis of all primary aldosteronism patients (n = 418) who underwent adrenal vein sampling (1997–2017).
Patients were classified by body mass index as obese (body mass index ≥35) or nonobese (body mass index <35) and diagnostic evaluation was compared between groups.
- Within the operative cohort (n = 285), primary outcomes were changes in both blood pressure and antihypertensive medications after adrenalectomy.
- Secondary outcome was clinical resolution by Primary Aldosteronism Surgery Outcomes criteria.