TY - JOUR
T1 - Drug-resistant hypertension in primary aldosteronism patients undergoing adrenal vein sampling
T2 - the AVIS-2-RH study
AU - Rossi, Gian Paolo
AU - Rossitto, Giacomo
AU - Amar, Laurence
AU - Azizi, Michel
AU - Riester, Anna
AU - Reincke, Martin
AU - Degenhart, Christoph
AU - Widimsky, Jiri
AU - Naruse, Mitsuhide
AU - Deinum, Jaap
AU - Schultze Kool, Leo
AU - Kocjan, Tomaz
AU - Negro, Aurelio
AU - Rossi, Ermanno
AU - Kline, Gregory
AU - Tanabe, Akiyo
AU - Satoh, Fumitoshi
AU - Rump, Lars Christian
AU - Vonend, Oliver
AU - Willenberg, Holger S.
AU - Fuller, Peter J.
AU - Yang, Jun
AU - Chee, Nicholas Yong Nian
AU - Margill, Steven B.
AU - Shafigullina, Zulfiya
AU - Quinkler, Marcus
AU - Oliveras, Anna
AU - Lee, Bo Ching
AU - Wu, Vin Cent
AU - Kratka, Zuzana
AU - Seccia, Teresa M.
AU - Lenzini, Livia
N1 - Publisher Copyright:
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: [email protected].
PY - 2022/1
Y1 - 2022/1
N2 - 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 < 1*10-4) with a higher rate of RH in men than in women (23% vs. 15% P < 1*10-4). Of the 292 patients with resistant hypertension, 98 (34%) underwent unilateral AVS-guided adrenalectomy, which resolved BP resistance to antihypertensive treatment in all. 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.
AB - 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 < 1*10-4) with a higher rate of RH in men than in women (23% vs. 15% P < 1*10-4). Of the 292 patients with resistant hypertension, 98 (34%) underwent unilateral AVS-guided adrenalectomy, which resolved BP resistance to antihypertensive treatment in all. 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.
KW - Adrenal vein sampling
KW - Aldosterone
KW - Drug-resistant hypertension
KW - Primary aldosteronism
UR - http://www.scopus.com/inward/record.url?scp=85118562700&partnerID=8YFLogxK
U2 - 10.1093/eurjpc/zwaa108
DO - 10.1093/eurjpc/zwaa108
M3 - Article
C2 - 33742213
AN - SCOPUS:85118562700
SN - 2047-4873
VL - 29
SP - e85-e93
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 2
ER -