医学
原发性醛固酮增多症
盐皮质激素受体
前瞻性队列研究
醛固酮
泌尿科
内科学
单中心
肾上腺切除术
血压
队列
动态血压
血浆肾素活性
内分泌学
胃肠病学
外科
肾素-血管紧张素系统
作者
Yajun Zhou,Qiting Liu,Xinquan Wang,Jindong Wan,Sen Liu,T. Luo,Ping He,Jixin Hou,Pu Jing,Dan Wang,De‐Yong Liang,Yi Yang,Peijian Wang
出处
期刊:American Journal of Hypertension
[Oxford University Press]
日期:2022-10-07
卷期号:35 (12): 1014-1023
被引量:6
摘要
Abstract Background Superselective adrenal arterial embolization (SAAE) is an alternative treatment for patients with primary aldosteronism (PA). This single-center prospective cohort study aimed to compare the efficacy of SAAE with mineralocorticoid receptor antagonists (MRA) in treating patients with PA who refused unilateral adrenalectomy. Methods Of the 140 PA patients who were enrolled in the study and completed 12-month follow-up, 74 patients underwent SAAE and 66 received MRA treatment. The clinical and biochemical outcome was compared at 1, 6, and 12 months after the procedure. Results Baseline clinical and biochemical characteristics of the patients were similar between groups. Office, home, and ambulatory blood pressure reduction at 1 month after discharge was more pronounced in the SAAE group than MRA group (all P < 0.05) while the blood pressure reduction was comparable between the 2 groups at 6 and 12 months. Patients who underwent SAAE took less antihypertensive medications than the MRA group during 12-month follow-up (P < 0.01). Both SAAE and MRA treatment improved renin suppression, aldosterone-to-renin ratio elevation, and hypokalemia at 6 and 12 months, whereas only SAAE but not MRA reduced plasma aldosterone levels. Moreover, SAAE achieved higher rates of complete clinical and biochemical success than MRA (both P < 0.01). Logistic regression found that complete clinical and biochemical success was only directly associated with diagnosis of unilateral PA in contrast to bilateral PA (P < 0.01). Conclusions The present study provides evidence that SAAE is a reasonable choice of treatment in patients with either unilateral or bilateral PA in terms of clinical and biochemical outcomes. This study was registered at Chictr.org.cn (ChiCTR2100045896).
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