Purpose of this research was to determine the appropriate time for outcome measurement and the necessary follow-up length. Researchers wanted to examine the postoperative trend in blood pressure (BP)-related outcomes [BP and antihypertensive (AHT) drug use] during the year following adrenalectomy for primary aldosteronism (PA). The best time to assess results and how long to follow up is unclear because the natural history of BP-related outcomes after adrenalectomy is uncertain. The data used in this retrospective single-center cohort study was gathered prospectively from a database of all patients admitted for investigation of hypertension that was difficult to control. All individuals with PA who underwent adrenalectomy were considered. Within the first postoperative year, data on AHT medication use [in defined daily dose (DDD)] and home blood pressure readings (HBPMs) were gathered. To examine the consistency of DDD and HBPM across time and to control for relevant confounders, a mixed-effects model was constructed. Out of a total of 1,784 patients evaluated for hypertension that was difficult to manage, 41 were included in the study. First postoperative month DDD and HBPM levels were significantly lower than preoperative values (mean 1.6DDD; mean 140/85 mm Hg vs. 4.5DDD; 153/92 mm Hg). From 4 to 6 months (1.6DDD; 136/86 mm Hg) and 12 months (2.0DDD; 136/83 mm Hg), both results remained steady. According to the results of this study, both AHT medication use and HBPM dropped significantly within the first month following adrenalectomy for PA and remained steady thereafter. They argued that the necessity of normal long-term follow-up at referral centers could be questioned if BP-related outcomes can be assessed reliably early on.
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