Ying Jing1, Kangla Liao2, Ruolin Li1, Shumin Yang1, Ying Song1, Wenwen He1, Kanran Wang1, Jun Yang3,4, Qifu Li1, Jinbo Hu1. 1. Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 2. Department of Cardiovascular, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 3. Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia. 4. Department of Medicine, Monash University, Clayton, VIC, Australia.
Abstract
OBJECTIVES: To compare the effect of surgical or medical treatment on the risk of cardiovascular diseases (CVD) and all-cause mortality in patients with established primary aldosteronism (PA). METHODS: We searched PUBMED, MEDLINE and Cochrane Library for the meta-analysis. We included patients who were diagnosed with PA following guideline-supported protocols and received surgery or mineralocorticoid receptor antagonist (MRA)-based medical treatment, and age-sex matched patients with treated essential hypertension (EH). Primary endpoints were CVD incidence and all-cause mortality. RESULTS: Compared with EH, patients with treated PA had a higher risk of CVD [odds ratio (OR) 1.79; 95% confidence interval (CI) 1.39-2.31]. This elevated risk was only observed in patients with medically treated PA [OR 2.11; 95%CI 1.88-2.38] but not in those with surgically treated PA. The risk of all-cause mortality was significantly lower in patients with treated PA [OR 0.86; 95% CI 0.77-0.95] compared to EH. The reduced risk was only observed in patients with surgically treated PA [OR 0.47; 95% CI 0.34-0.66], but not in those with medically treated PA. CONCLUSIONS: Patients with medically treated PA have a higher risk of CVD compared to patients with EH. Surgical treatment of PA reduces the risk of CVD and all-cause mortality in patients with PA.
OBJECTIVES: To compare the effect of surgical or medical treatment on the risk of cardiovascular diseases (CVD) and all-cause mortality in patients with established primary aldosteronism (PA). METHODS: We searched PUBMED, MEDLINE and Cochrane Library for the meta-analysis. We included patients who were diagnosed with PA following guideline-supported protocols and received surgery or mineralocorticoid receptor antagonist (MRA)-based medical treatment, and age-sex matched patients with treated essential hypertension (EH). Primary endpoints were CVD incidence and all-cause mortality. RESULTS: Compared with EH, patients with treated PA had a higher risk of CVD [odds ratio (OR) 1.79; 95% confidence interval (CI) 1.39-2.31]. This elevated risk was only observed in patients with medically treated PA [OR 2.11; 95%CI 1.88-2.38] but not in those with surgically treated PA. The risk of all-cause mortality was significantly lower in patients with treated PA [OR 0.86; 95% CI 0.77-0.95] compared to EH. The reduced risk was only observed in patients with surgically treated PA [OR 0.47; 95% CI 0.34-0.66], but not in those with medically treated PA. CONCLUSIONS: Patients with medically treated PA have a higher risk of CVD compared to patients with EH. Surgical treatment of PA reduces the risk of CVD and all-cause mortality in patients with PA.
Authors: Martin Reincke; Evelyn Fischer; Sabine Gerum; Katrin Merkle; Sebastian Schulz; Anna Pallauf; Marcus Quinkler; Gregor Hanslik; Katharina Lang; Stefanie Hahner; Bruno Allolio; Christa Meisinger; Rolf Holle; Felix Beuschlein; Martin Bidlingmaier; Stephan Endres Journal: Hypertension Date: 2012-07-23 Impact factor: 10.190
Authors: Heike E Künzel; Konstantina Apostolopoulou; Anna Pallauf; Sabine Gerum; Katrin Merkle; Sebastian Schulz; Evelyn Fischer; Volker Brand; Martin Bidlingmaier; Stephan Endres; Felix Beuschlein; Martin Reincke Journal: J Psychiatr Res Date: 2012-09-25 Impact factor: 4.791
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