Vol 9, No 1 (2005)
Original paper
Published online: 2005-02-04
Analysis of pathogenetic factors of persistent hypertension in patients with pheochromocytoma who underwent unilateral adrenalectomy
Nadciśnienie tętnicze 2005;9(1):22-30.
Abstract
Background Surgery is a method of choice in the treatment of patients with pheochromocytoma. The aim of
the study was to analyse factors which participate in pathogenesis of persistent hypertension in patients who
underwent unilateral adrenalectomy due to pheochromocytoma.
Material and methods In the analysed group of 25 patients mean value of maximal systolic blood pressure (SBP) before surgery was 232.6 ± 38.5 mm Hg, and diastolic (DBP) 133.3 ± 22.2 mm Hg. In 40% of patients arterial hypertension was permanent, and in 60% — paroxysmal. Mean maximal tumour size in diagnostic imaging was 58.1 ± 19.6 mm. Mean time of observation after adrenalectomy was 48.0 ± 28.4 months.
Results A significant decrease of maximal SBP and DBP after surgery was achieved (–85.9 ± 36.9 and –44.1 ± 22.8 mm Hg respectively). A positive correlation between decrease of SBP and DBP after surgery and maximal tumour size was revealed. Accidental value of SBP measured in patients after surgery was 124.6 ± 18.3 mm Hg, and DBP — 79.0 ± 9.2 mm Hg. In 56% of patients accidental blood pressure values were lower than 140/90 mm Hg without any antihipertensive drugs. In patients who required pharmacological therapy significant longer duration of arterial hypertension before adrenalectomy (mean 76.3 ± 63.5 vs. 30.5 ± 44.1 months) and older age of patients at the time of surgery (mean 46.4 ± 10.2 vs. 38.3 ± 9.8 years) were observed.
Conclusions In patients with arterial hypertension due to pheochromocytoma adrenalectomy leads to a permanent improvement of maximal values of systolic and diastolic blood pressure. Longer duration of arterial hypertension before surgery and older age of patients ignificantly contribute to worse results of adrenalectomy and necessity of antihipertensive therapy in order to keep blood pressure values in the normal range.
Material and methods In the analysed group of 25 patients mean value of maximal systolic blood pressure (SBP) before surgery was 232.6 ± 38.5 mm Hg, and diastolic (DBP) 133.3 ± 22.2 mm Hg. In 40% of patients arterial hypertension was permanent, and in 60% — paroxysmal. Mean maximal tumour size in diagnostic imaging was 58.1 ± 19.6 mm. Mean time of observation after adrenalectomy was 48.0 ± 28.4 months.
Results A significant decrease of maximal SBP and DBP after surgery was achieved (–85.9 ± 36.9 and –44.1 ± 22.8 mm Hg respectively). A positive correlation between decrease of SBP and DBP after surgery and maximal tumour size was revealed. Accidental value of SBP measured in patients after surgery was 124.6 ± 18.3 mm Hg, and DBP — 79.0 ± 9.2 mm Hg. In 56% of patients accidental blood pressure values were lower than 140/90 mm Hg without any antihipertensive drugs. In patients who required pharmacological therapy significant longer duration of arterial hypertension before adrenalectomy (mean 76.3 ± 63.5 vs. 30.5 ± 44.1 months) and older age of patients at the time of surgery (mean 46.4 ± 10.2 vs. 38.3 ± 9.8 years) were observed.
Conclusions In patients with arterial hypertension due to pheochromocytoma adrenalectomy leads to a permanent improvement of maximal values of systolic and diastolic blood pressure. Longer duration of arterial hypertension before surgery and older age of patients ignificantly contribute to worse results of adrenalectomy and necessity of antihipertensive therapy in order to keep blood pressure values in the normal range.
Keywords: pheochromocytomaarterial blood pressurearterial hypertensionadrenalectomy