Cardiometabolic Burden in Bilateral Macronodular Adrenal Disease With Primary Aldosteronism - PubMed
3 hours ago
- #Bilateral Macronodular Adrenal Disease
- #Primary Aldosteronism
- #Cardiometabolic Burden
- Bilateral macronodular adrenocortical disease (BMAD) often involves primary aldosteronism (PA) and is associated with a high cardiometabolic burden.
- The study included 249 patients from 41 centers across 12 countries, with a median age of 55 years and 62% male; median hypertension duration was 9.9 years at PA diagnosis.
- Among tested patients, 52% had cortisol cosecretion and 47% had isolated PA; at baseline, 56% had metabolic comorbidities, and 16% had at least one major adverse cardiovascular event (MACE).
- Patients with MACE were older, more often male, had longer hypertension duration, and higher diabetes rates.
- Treatment outcomes showed MACE rates of 8% in MRA-treated patients and 6% in adrenalectomy patients over a median follow-up of 36 vs. 18 months, respectively, with no significant difference.
- Adrenal venous sampling indicated lateralized PA in 89% of surgical patients versus 19% of MRA-treated patients.
- Blood pressure and organ damage were similar between groups, but more MRA-treated patients required three or more antihypertensives (48% vs. 14% for adrenalectomy).
- Among operated patients, complete clinical success was 26% and biochemical success was 71%.
- Early detection and precise subtyping are crucial for optimizing management and preventing target organ damage in BMAD with PA.