Publication
Hiperaldosteronismo primário: resultados do primeiro estudo multicêntrico português realizado pelo Grupo de Estudos de Tumores da Supra-Renal
| dc.contributor.author | Fernandes, V | |
| dc.contributor.author | Silva, T | |
| dc.contributor.author | Martins, D | |
| dc.contributor.author | Gonçalves, D | |
| dc.contributor.author | Almeida, R | |
| dc.contributor.author | Monteiro, AM | |
| dc.contributor.author | Neves, C | |
| dc.contributor.author | Simões, H | |
| dc.contributor.author | Marques, P | |
| dc.contributor.author | Serra, F | |
| dc.contributor.author | Pereira, ML | |
| dc.contributor.author | Grupo de Estudos de Tumores da Supra-Renal | |
| dc.date.accessioned | 2016-07-17T20:44:24Z | |
| dc.date.available | 2016-07-17T20:44:24Z | |
| dc.date.issued | 2016 | |
| dc.description.abstract | Introduction: Primary Aldosteronism (PA) is the most prevalent cause of secondary hypertension. Nevertheless, there is no portuguese multicenter study characterizing PA patients. Aims: To characterize the clinical presentation, diagnostic workup, treatment and follow-up of patients with confirmed PA. Methods: Retrospective multicenter study of PA patients followed in 9 portuguese hospitals. Results: Sixty-three cases were selected with a mean age of diagnosis of 52.1 ± 13.1 years, 9.9 years after the diagnosis of hypertension. At presentation, 37 cases (60.7%) had hypertension, 11 (22.9%) had resistant hypertension and 20 (32.8%) of patients had hipokalemia (mean 3.2 mmol/L). Baseline laboratory showed a mean serum aldosterone of 33.4ng/dL, plasmatic renin activity (PRA) of 0.2ng/mL/h with an aldosterone/PRA ratio of 97.1. Confirmatory testing was performed with saline infusion in 55 patients (positive in 84.4%) and captopril test in 14 (positive in 85.7%). Imaging showed adenomas in 55 cases, hyperplasia in 2 and bilateral cases in 8. Arterial venous sampling (AVS) was performed in 9 patients (14,5%) and was conclusive in 1. Iodocholesterol scintigraphy was done in 14 cases (22%) with unilateral fixation in 9 and no fixation in 4. Patients were treated with laparoscopic adrenalectomy in 28 cases (58.3%) and mineralocorticoid receptor antagonists in 20 cases (41.7%). The surgical treated group had less duration of hypertension (8 versus 14 years, p = 0.002), higher prevalence of anti-hypertensive drugs at presentation (100 versus 75% p = 0.009) and bigger tumour size (1.8 versus 1.5 cm, p = 0.022). During follow-up there was a trend towards a greater proportion of patients with no hypertension improvement in the medical treatment group (29.4% versus 7.4%, p = 0.089). Conclusion: This is the first Portuguese PA multicenter study. It suggests that PA remains an under- -diagnosed condition with a significant delay in diagnosis. Surgical treated patients had a more aggressive disease and showed a trend towards better hypertension control. | pt_PT |
| dc.identifier.citation | Rev Port Endocrinol Diabetes Metab. 2016;xxx(xx):xxx–xxx | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.23/1068 | |
| dc.language.iso | por | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.subject | Hiperaldosteronismo | pt_PT |
| dc.subject | Aldosterona | pt_PT |
| dc.title | Hiperaldosteronismo primário: resultados do primeiro estudo multicêntrico português realizado pelo Grupo de Estudos de Tumores da Supra-Renal | pt_PT |
| dc.title.alternative | Primary Aldosteronism: results from the first Portuguese multicentre study by the adrenal tumour study group | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |