Majority of patients with hypertension have primary hypertension (without an underlying cause). Primary aldosteronism (PA) is the most common cause of secondary hypertension, and can be found in 5-10% of patients locally. PA is caused by excessive release of a hormone (aldosterone) from the adrenal glands, which can be unilateral (one gland) or bilateral (both glands). It has been shown that excess aldosterone has other harmful effects in addition to hypertension, such as directly affecting the heart, blood vessels, kidneys, leading to increased cardiovascular morbidity and mortality. This is supported by studies showing reversal of these effects after treatment for PA. The investigators aim to assess the long-term cardiovascular, and renal outcomes of patients with PA, compared to patients with essential hypertension.
Study Type
OBSERVATIONAL
Enrollment
600
Unilateral adrenalectomy in patients with unilateral disease
Changi General Hospital
Singapore, Singapore
RECRUITINGchange in systolic blood pressure before and after treatment
change in systolic blood pressure
Time frame: six months after treatment
change in diastolic blood pressure before and after treatment
change in diastolic blood pressure
Time frame: six months after treatment
change in systolic blood pressure before and after treatment
change in systolic blood pressure
Time frame: through study completion, an average of 5 years
change in diastolic blood pressure before and after treatment
change in diastolic blood pressure
Time frame: through study completion, an average of 5 years
cardiovascular outcome
incidence of new cardiovascular events including acute myocardial infarction, revascularisation percutaneously, coronary artery bypass graft, stroke, admission for congestive cardiac failure, atrial fibrillation
Time frame: through study completion, an average of 5 years
chronic kidney disease
incidence of worsening chronic kidney disease, decline of glomerular filtration rate by 15ml/min from at least 60m/min
Time frame: through study completion, an average of 5 years
Renal Progression
rate of decline of glomerular filtration rate
Time frame: through study completion, an average of 5 years
variables that predict unilateral disease
Identify variables that are more common in patients with unilateral disease
Time frame: through study completion, an average of 5 years
variables that predict blood pressure response
Identify variables that are more common in patients with positive blood pressure response
Time frame: through study completion, an average of 5 years
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