1. Drug-resistant hypertension in primary aldosteronism patients undergoing adrenal vein sampling: the AVIS-2-RH study
- Author
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Ermanno Rossi, Akiyo Tanabe, Steven B Margill, Gian Paolo Rossi, Holger S. Willenberg, Marcus Quinkler, Lars Christian Rump, Mitsuhide Naruse, Aurelio Negro, Giacomo Rossitto, Zulfiya Shafigullina, Anna Riester, Michel Azizi, Leo J. Schultze Kool, Teresa Maria Seccia, Bo-Ching Lee, Peter J. Fuller, Vin-Cent Wu, Jaap Deinum, Nicholas Yong Nian Chee, Jiri Widimsky, Livia Lenzini, Laurence Amar, Zuzana Krátká, Oliver Vonend, Tomaz Kocjan, Martin Reincke, Anna Oliveras, Gregory A. Kline, Fumitoshi Satoh, Christoph Degenhart, Jun Yang, CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Epidemiology ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Drug resistance ,030204 cardiovascular system & hematology ,Drug-resistant hypertension ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Primary aldosteronism ,Internal medicine ,Adrenal Glands ,Hyperaldosteronism ,medicine ,Humans ,In patient ,Adrenal vein sampling ,030212 general & internal medicine ,Aldosterone ,Retrospective Studies ,business.industry ,Adrenalectomy ,medicine.disease ,Optimal management ,Blood pressure ,chemistry ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims We aimed at determining the rate of drug-resistant arterial hypertension in patients with an unambiguous diagnosis of primary aldosteronism (PA). Moreover, we sought for investigating the diagnostic performance of adrenal vein sampling (AVS), and the effect of adrenalectomy on blood pressure (BP) and prior treatment resistance in PA patients subtyped by AVS in major referral centres. Methods and results The Adrenal Vein Sampling International Study-2 (AVIS-2) was a multicentre international study that recruited consecutive PA patients submitted to AVS, according to current guidelines, during 15 years. The patients were over 18 years old with arterial hypertension and had an unambiguous diagnosis of PA. The rate of resistant hypertension was assessed at baseline and after adrenalectomy using the American Heart Association (AHA) 2018 definition. Information on presence or absence of resistant hypertension was available in 89% of the 1625 enrolled PA patients. Based on the AHA 2018 criteria, resistant hypertension was found in 20% of patients, of which about two-thirds (14%) were men and one-third (6%) women (χ2 = 17.1, P Conclusions (i) Resistant hypertension is a common presentation in patients seeking surgical cure of PA; (ii) AVS is key for the optimal management of patients with PA due to resistant hypertension; and (iii) AVS-guided adrenalectomy allowed resolution of treatment-resistant hypertension.
- Published
- 2022
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