Surgical treatment of hypertension: Preoperative work-up and surgical treatment of primary aldosteronism in current daily practice

Abstract

Primary aldosternism (PA) is the most common cause of secondary hypertension and is due to an inappropriate production of aldosterone by one or both adrenal glands. Approximately 5% of patients with hypertension suffers from PA which equals 1% of the worldwide adult population. PA is characterized by severe hypertension not responding to antihypertensive medications. Through fibrosis of vessels, hearth and kidneys PA leads to diseases such as heart attacks, hearth failure or kidney failure. PA can be treated with a relatively small and safe operation. Current literature however lacks valid data on the precise benefits of this operation in terms of reduction of blood pressure and/or antihypertensive medications. Within this dissertation we focused on complementing this lacuna in literature. The results of our research showed an evident reduction in blood pressure and/or antihypertensive medications in more than 90% of the patients. More than 25% of patients was completely cured from hypertension and therefore were free of antihypertensive medications. Moreover, an additional 31% of patients became normotensive on equal or lower antihypertensive medications. Therefore, this dissertations shows high benefits of surgery in patients with PA.