evaluation of predictive risk factors of persistent hypertension in hyperaldosteronism after surgery

Background: primary hyperaldosteronism (pha) is a common cause of secondary arterial hypertension (ah), characterized by autonomous aldosterone secretion. it is frequently underdiagnosed and may persist even after surgical intervention. objectives: the present study aimed to identify preoperative factors that could predict whether hypertension would persist or normalize following surgery and to outline relevant diagnostic characteristics. methods: we conducted a descriptive, analytic, retrospective cohort study at a single center. the study included patients with pha who were followed up at the department of endocrinology, diabetology, and nutrition in a hospital affiliated with mohamed the first university of oujda (cerbo), admitted between december 2014 and august 2023. data were retrospectively collected from patient records over a 9-year period, involving 27 patients with pha confirmed by an elevated aldosterone-to-renin ratio (arr). persistent disease was defined by persistent hypokalemia and hypertension (blood pressure > 140/90 mm hg) after six months. patients were divided into two groups: those with complete resolution of hypertension (group a) and those with persistent hypertension (group b). data were analyzed using spss version 21. results: the mean age of patients was 48.47 ± 10.87 years, with a female predominance (66.7%). the etiological assessment identified conn’s adenoma in 70.4% (n = 19) of cases and bilateral adrenal hyperplasia in 29.6% (n = 8). surgery was performed in 51.9% (n = 14) of cases, with 50% (n = 7) maintaining persistent hypertension post-surgery, while 28.6% (n = 4) showed a reduction in antihypertensive medications. two predictive factors for persistent hypertension were identified: age > 50 years and hypertension duration > 5 years. predictive factors for normalization of hypertension post-surgery included systolic blood pressure (sbp) < 140 mm hg, diastolic blood pressure (dbp) < 90 mm hg, glomerular filtration rate (gfr) > 90 ml/min/1.75 m2, and a low incidence of diabetes and dyslipidemia. conclusions: this study demonstrates that pha can lead to resistant hypertension, highlighting the necessity for further research in this area.