{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:10:38Z","timestamp":1784232638103,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aims to determine the impact of patient obesity on the resolution of hypertension and pill burden post\u2010adrenalectomy for PA. Primary hyperaldosteronism (PA) is the most common cause of secondary hypertension that may be remedied with surgery (unilateral adrenalectomy). Obesity may independently cause hypertension through several mechanisms including activation of the renin\u2013angiotensin\u2013aldosterone pathway. The influence of obesity on the efficacy of adrenalectomy in PA has not been established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis of prospectively collected data on patients undergoing adrenalectomy for PA at a single, tertiary\u2010care surgical centre from January 2015 to December 2020. Electronic health records of patients were screened to collect relevant data. The primary outcomes of the study include post\u2010operative blood pressure, the reduction in the number of anti\u2010hypertensive medications and potassium supplementation burden post\u2010adrenalectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010three patients were included in the final analysis. There was a significant reduction in the blood pressure and the number of anti\u2010hypertensive medications in all patients after adrenalectomy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Of the 34 patients (64.2%) with pre\u2010operative hypokalaemia, all became normokalaemic and were able to stop supplementation. However obese patients required more anti\u2010hypertensive medications to achieve an acceptable blood pressure than overweight or normal BMI patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Multivariate logistic regression analysis showed that male gender and BMI were independent predictors of resolution of hypertension (<jats:italic>p<\/jats:italic>\u2009&lt;0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unilateral adrenalectomy improves the management of hypertension and hypokalaemia when present in patients with PA. However, obesity has an independent deleterious impact on improvement in blood pressure post\u2010adrenalectomy for PA.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07021-5","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T18:02:21Z","timestamp":1689357741000},"page":"2188-2196","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Obesity on the Resolution of Hypertension Following Adrenalectomy for Primary Hyperaldosteronism"],"prefix":"10.1002","volume":"47","author":[{"given":"Swathikan","family":"Chidambaram","sequence":"first","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Division of Surgery, Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaas","family":"Van Den Heede","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Department of General and Endocrine Surgery OLV Hospital Aalst Aalst Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Damji","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Meeran","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Department of Medicine Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie","family":"Todd","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Department of Medicine Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Wernig","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Department of Medicine Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Palazzo","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Division of Surgery, Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee N.","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery Imperial College Healthcare NHS Trust, Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Division of Surgery, Department of Surgery and Cancer Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"3","article-title":"Primary aldosteronism, a new clinical syndrome","volume":"45","author":"Conn JW","year":"1955","journal-title":"J Lab Clin Med"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(08)60834\u2010X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30319\u20104"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30135\u20103"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003200"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318165c075"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/7.10.886"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2017.78"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101139\u20101783"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/08037051.2018.1527177"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015\u20104061"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3283060f0c"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez\u2010MuniesaP M\u00e1rtinez\u2010Gonz\u00e1lezMA HuFB et al. (2017)Obesity. Nat Rev Dis Prim","DOI":"10.1038\/nrdp.2017.34"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.07\u20109412com"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008\u20100251"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.111369"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2010.95"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.08.001"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11255\u2010017\u20101705\u20109"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010135\u20104\u2010200108210\u201000010"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010004\u20107496\u2010z"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12012"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(16)30424\u20107"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9744"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07021-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-023-07021-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-023-07021-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-023-07021-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T16:31:14Z","timestamp":1703349074000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-023-07021-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1007\/s00268-023-07021-5"],"URL":"https:\/\/doi.org\/10.1007\/s00268-023-07021-5","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]},"assertion":[{"value":"8 April 2023","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2023","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors have completed the ICMJE uniform disclosure form at  and declare that there is no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This research was done without patient involvement. Patients were not invited to comment on the study design and were not consulted to develop patient relevant outcomes or interpret the results. Patients were not invited to contribute to the writing or editing of this document for readability or accuracy. Patient involvement with and understanding of the outcomes is important and it is planned that the outcomes will be disseminated via patient groups for PA and for bariatric surgery.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient and public involvement"}}]}}