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Fat mass as an important predictor of persistent hypertension in patients with primary aldosteronism after adrenalectomy

Hypertension Research volume 46, pages 1375–1384 (2023)Cite this article

A Comment to this article was published on 10 April 2023

Abstract

Aldosterone excess is present in obesity and is associated with involvement in the pathogenesis of obesity. We evaluate the impact of body obesity as measured by body composition monitor (BCM) on clinical outcomes in patients with unilateral primary aldosteronism (uPA) after adrenalectomy. The BCM device was used to assess body composition before and after adrenalectomy. We used fat mass (FM) and body mass index (BMI) to classify obesity and divided obesity into three groups: clinical overweight (BMI (kg/m2) ≥25); normal weight obesity (NWO, FM (%) ≥ 35 for women, >25 for men & BMI < 25); and no obesity (FM < 35 for women, <25 for men & BMI < 25). A total of 130 unilateral PA (uPA) patients received adrenalectomy, and 27 EH patients were identified; uPA patients with hypertension remission were found to have lower FM (p = 0.046), BMI (p < 0.001), and lower prevalence of overweight (p = 0.001). In the logistic regression model, patients with clinical overweight (OR = 2.9, p = 0.007), NWO (OR = 3.04, p = 0.041) and longer HTN duration (years, OR = 1.065, p = 0.013) were at the risk of persistent hypertension after adrenalectomy. Obesity status was strongly associated with persistent hypertension in uPA patients after adrenalectomy. However, patients in the NWO group also carried higher risk of persistent hypertension. Therefore, assessment of pre-obesity and overweight in uPA patients are extremely important, especially in those who have normal BMI.

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Acknowledgements

The authors greatly appreciate the Second Core Lab in National Taiwan University Hospital for technical assistance and Member of TAIPAI group (https://doi.org/10.6084/m9.figshare.21669929).

Funding

This study was supported by Ministry of Science and Technology (MOST) of the Republic of China (Taiwan) [grant number, MOST 107-2314-B-002-026-MY3, 108-2314-B-002-058, 110-2314-B-002-241, 110-2314-B-002-239, 111-2314-B-075-011-MY3], National Science and Technology Council (NSTC) [grant number, NSTC 109-2314-B-002-174-MY3, 110-2314-B-002-124-MY3, 111-2314-B-002-046, 111-2314-B-002-058], National Health Research Institutes [PH-102-SP-09], National Taiwan University Hospital [109-S4634, PC-1246, PC-1309, VN109-09, UN109-041, UN110-030, 111-FTN0011] Grant MOHW 110-TDU-B-212-124005 and Mrs Hsiu-Chin Lee Kidney Research Fund. (https://doi.org/10.6084/m9.figshare.21670460) The funds played no role in the design or conduct of the study, in the collection, management, analysis, or interpretation of the data, nor in the preparation, review, or approval of the paper.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Wei-Chieh Huang & Tse-Min Lu

  2. School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Wei-Chieh Huang, Liang-Yu Lin, Chii-Min Hwu & Tse-Min Lu

  3. Division of Cardiology Department of Internal Medicine New Taipei City Hospital, New Taipei City, Taiwan

    Wei-Chieh Huang & LiWei Chen

  4. Division of Nephrology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan

    Ying-Ying Chen

  5. Department of Medicine, Mackay Medical College, New Taipei, Taiwan

    Ying-Ying Chen

  6. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Ying-Ying Chen, Shao-Yu Yang, Chun-Fu Lai, Tai-Shuan Lai, Yen-Hung Lin & Vin-Cent Wu

  7. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Shao-Yu Yang, Chun-Fu Lai, Tai-Shuan Lai, Yen-Hung Lin & Vin-Cent Wu

  8. Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan

    Hsiang-Yao Chen

  9. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Yi-Jen Wang

  10. Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK

    Yi-Jen Wang

  11. Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan

    Yu-Lun Cheng

  12. Department of Internal Medicine, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan

    Cheng-Lin Lang

  13. Division of Endocrinology, Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan

    Chih-Fan Chen & Hui-Fang Chang

  14. Department of Family Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Jen-Kuei Peng

  15. Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Jen-Kuei Peng

  16. Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Liang-Yu Lin & Chii-Min Hwu

  17. Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Hao-Min Cheng

  18. Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan

    Hao-Min Cheng

  19. Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan

    Hao-Min Cheng

  20. Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan

    Hao-Min Cheng

  21. Department of Urology, National Taiwan University Hospital, Taipei, Taiwan

    Jeff S. Chueh

  22. Primary Aldosteronism Center, National Taiwan University Hospital, (NTUH-PAC), Taipei, Taiwan

    Jeff S. Chueh, Yen-Hung Lin & Vin-Cent Wu

  23. TAIPAI, Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Taipei, Taiwan

    Jeff S. Chueh, Yen-Hung Lin & Vin-Cent Wu

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  1. Wei-Chieh Huang
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Contributions

WCH drafted the paper and collected data. V-CW provided the original concept and design of the study, critically modified the statistical models, and provided technical and statistical support during the analyses. All the authors interpreted and had full access to the data, critically revised the paper, and approved the final paper.

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Correspondence to Vin-Cent Wu.

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Huang, WC., Chen, YY., Yang, SY. et al. Fat mass as an important predictor of persistent hypertension in patients with primary aldosteronism after adrenalectomy. Hypertens Res 46, 1375–1384 (2023). https://doi.org/10.1038/s41440-023-01203-3

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