Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism
Abstract Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9–15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery. This s...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-05-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-03912-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850243038014603264 |
|---|---|
| author | Kawintharat Harirugsakul Swiss Suharitdumrong Kamol Panumatrassamee Supoj Ratchanon Manint Usawachintachit Dutsadee Sowanthip Pea Pobpan Gantapong Sainont Apirak Santingamkun |
| author_facet | Kawintharat Harirugsakul Swiss Suharitdumrong Kamol Panumatrassamee Supoj Ratchanon Manint Usawachintachit Dutsadee Sowanthip Pea Pobpan Gantapong Sainont Apirak Santingamkun |
| author_sort | Kawintharat Harirugsakul |
| collection | DOAJ |
| description | Abstract Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9–15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery. This study developed and validated a novel predictive scoring model for persistent hypertension following adrenalectomy based on 363 patients from a 25-year single-center experience. Persistent hypertension occurred in 59.5% of patients postoperatively. Multivariable analysis identified five independent predictors: age ≥ 50 years, dyslipidemia, BMI ≥ 25 kg/m2, use of ≥ 3 antihypertensive medications, and hypertension duration ≥ 5 years. The model demonstrated excellent discriminative ability with area under the curve of 0.81 in internal validation and 0.72 in external validation. Predictive risk scores were categorized into low-risk (0–1), intermediate-risk (2–3), and high-risk (4–5) groups, with persistent hypertension rates of 23.5%, 72.1%, and 90.6%, respectively. This practical scoring system enables improved preoperative counseling and individualized management planning using readily available clinical parameters. |
| format | Article |
| id | doaj-art-e06a6170a204491fbc55db2c7dc5041d |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-e06a6170a204491fbc55db2c7dc5041d2025-08-20T02:00:07ZengNature PortfolioScientific Reports2045-23222025-05-011511910.1038/s41598-025-03912-wNovel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronismKawintharat Harirugsakul0Swiss Suharitdumrong1Kamol Panumatrassamee2Supoj Ratchanon3Manint Usawachintachit4Dutsadee Sowanthip5Pea Pobpan6Gantapong Sainont7Apirak Santingamkun8Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyDivision of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyAbstract Primary aldosteronism (PA) is the most common endocrinologic hypertension, affecting 3.9–15% of hypertensive patients. While unilateral PA is potentially curable through adrenalectomy, a significant proportion of patients experience persistent hypertension despite successful surgery. This study developed and validated a novel predictive scoring model for persistent hypertension following adrenalectomy based on 363 patients from a 25-year single-center experience. Persistent hypertension occurred in 59.5% of patients postoperatively. Multivariable analysis identified five independent predictors: age ≥ 50 years, dyslipidemia, BMI ≥ 25 kg/m2, use of ≥ 3 antihypertensive medications, and hypertension duration ≥ 5 years. The model demonstrated excellent discriminative ability with area under the curve of 0.81 in internal validation and 0.72 in external validation. Predictive risk scores were categorized into low-risk (0–1), intermediate-risk (2–3), and high-risk (4–5) groups, with persistent hypertension rates of 23.5%, 72.1%, and 90.6%, respectively. This practical scoring system enables improved preoperative counseling and individualized management planning using readily available clinical parameters.https://doi.org/10.1038/s41598-025-03912-wAdrenalectomyPrimary aldosteronismHypertensionPredictive model |
| spellingShingle | Kawintharat Harirugsakul Swiss Suharitdumrong Kamol Panumatrassamee Supoj Ratchanon Manint Usawachintachit Dutsadee Sowanthip Pea Pobpan Gantapong Sainont Apirak Santingamkun Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism Scientific Reports Adrenalectomy Primary aldosteronism Hypertension Predictive model |
| title | Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| title_full | Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| title_fullStr | Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| title_full_unstemmed | Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| title_short | Novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| title_sort | novel predictive factors scoring model for persistent hypertension after adrenalectomy in patients with primary aldosteronism |
| topic | Adrenalectomy Primary aldosteronism Hypertension Predictive model |
| url | https://doi.org/10.1038/s41598-025-03912-w |
| work_keys_str_mv | AT kawintharatharirugsakul novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT swisssuharitdumrong novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT kamolpanumatrassamee novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT supojratchanon novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT manintusawachintachit novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT dutsadeesowanthip novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT peapobpan novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT gantapongsainont novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism AT apiraksantingamkun novelpredictivefactorsscoringmodelforpersistenthypertensionafteradrenalectomyinpatientswithprimaryaldosteronism |