10.18 Vascular Remodelling and Duration of Hypertension Predicts Blood Pressure Response to Adrenalectomy in Aldosterone
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High Blood Press Cardiovasc Prev 2007; 14 (3): 145-196 1120-9879/07/0003-0145/$44.95/0 © 2007 Adis Data Information BV. All rights reserved.
Vessels and Endothelium 10.18 Vascular Remodelling and Duration of Hypertension Predicts Blood Pressure Response to Adrenalectomy in Aldosterone-Producing Adenoma Patients G. P. Rossi,1 M. Bolognesi,1 D. Rizzoni,2 A. Piva,1 E. Porteri,2 P. Bernante,3 G. Pitter,1 E. Agabiti-Rosei,2 A. C. Pessina (1) Department of Clinical and Experimental Medicine, Pa Padova; (2) Internal Medicine, Br Brescia; (3) Department of Medical and Surgical Sciences, Padova, It Italy Introduction: An increased media-to-lumen (M/L) ratio of resistance arteries is a hallmark of arterial hypertension and cardiovascular events. However, it remains unclear if it predicts the blood pressure response to adrenalectomy in patients with an aldosterone-producing adenoma (APA). Objective: To test the hypothesis that the M/L ratio is useful for identifying the APA patients who will benefit from adrenalectomy. Methods: We prospectively measured the M/L of 150-300 μm diameter arteries isolated from fat tissue surrounding the adrenal gland of 46 patients (18 m and 28 f, 55±12 yrs) at the time of adrenalectomy for an APA. The outcome of adrenalectomy on blood pressure was assessed by considering also the number and dosages of antihypertensive medications. Results: Adrenalectomy significantly reduced aldosterone/renin ratio (from 86±35 to 8±2) and blood pressure levels (from 163±22/99±15 mmHg mmHg to 133±15/83±8), even despite a significant reduction of antihypertensive treatment score (from 142±14 to 100±13, p
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