{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:19:04Z","timestamp":1793758744108,"version":"4.6.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"\n Objective<\/jats:title>\n Long-term outcomes (especially mortality and\/or major cardiovascular events (MACE)) of the unilateral primary aldosteronism (uPA) patients who underwent medical or surgery-targeted treatment, relative to those with essential hypertension (EH), have been scarcely reported.<\/jats:p>\n <\/jats:sec>\n \n Design and settings<\/jats:title>\n Using the prospectively designed observational Taiwan Primary Aldosteronism Investigation cohort, we identified 858 uPA cases among 1220 primary aldosteronism patients and another 1210 EH controls.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Operated uPA patients were grouped via their 1-year post-therapy statuses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Primary Aldosteronism Surgical Outcome clinical complete success (hypertension remission) was achieved in 272 (49.9%) of 545 surgically treated uPA patients. After follow-up for 6.3 \u00b1 4.0 years, both hypertension-remissive (hazard ratio (HR): 0.54;\n P<\/jats:italic>\n \u2009 < 0.001) and not-cured (HR: 0.61;\n P<\/jats:italic>\n \u2009 < 0.001) uPA patients showed a lower risk of all-cause mortality than that of EH controls; whereas the not-cured group had a higher risk of incident MACE (sub-hazard ratio (sHR), 1.41;\n P<\/jats:italic>\n \u2009=\u20090.037) but similar atrial fibrillation (Af) and congestive heart failure (CHF). Mineralocorticoid receptor antagonist (MRA)-treated uPA patients had higher risks of MACE (sHR: 1.38;\n P<\/jats:italic>\n \u2009=\u20090.033), Af (sHR:1.62,\n P<\/jats:italic>\n \u2009=\u20090.049), and CHF (sHR: 1.44;\n P<\/jats:italic>\n \u2009=\u20090.048) than those of EH controls, with mortality as a competing risk. Using inverse probability of treatment-weighted matching and counting adrenalectomy as a time-varying factor, treatment with adrenalectomy was associated with lower risks of all-cause mortality (HR: 0.57;\n P<\/jats:italic>\n \u2009=\u20090.035), MACE (HR: 0.67;\n P<\/jats:italic>\n \u2009=\u20090.037), and CHF (HR: 0.49;\n P<\/jats:italic>\n \u2009=\u20090.005) compared to those of MRA therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Adrenalectomy, independent of post-surgical hypertension remission, was associated with lower all-cause mortality of uPA patients, compared to that of EH patients. We further documented a more beneficial effect of adrenalectomy over MRA treatment on long-term mortality, MACE, and CHF in uPA patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/eje-21-0836","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T12:17:39Z","timestamp":1638361059000},"page":"195-205","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-7","source":"Crossref","is-referenced-by-count":66,"title":["Long-term mortality and cardiovascular events in patients with unilateral primary aldosteronism after targeted treatments"],"prefix":"10.1093","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7935-0991","authenticated-orcid":true,"given":"Vin-Cent","family":"Wu","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo-Meng","family":"Wang","sequence":"additional","affiliation":[{"name":"2Department of Urology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-How","family":"Huang","sequence":"additional","affiliation":[{"name":"2Department of Urology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao Chou","family":"Tsai","sequence":"additional","affiliation":[{"name":"3Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh-Kai","family":"Chan","sequence":"additional","affiliation":[{"name":"4Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-Yu","family":"Yang","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-4866","authenticated-orcid":true,"given":"Chin-Chen","family":"Chang","sequence":"additional","affiliation":[{"name":"5Department of Imaging Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Chu","family":"Lu","sequence":"additional","affiliation":[{"name":"6Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0713-4904","authenticated-orcid":true,"given":"Jeff S","family":"Chueh","sequence":"additional","affiliation":[{"name":"2Department of Urology, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/186\/2\/EJE-21-0836.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/downloadpdf\/journals\/eje\/186\/2\/EJE-21-0836.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T11:17:11Z","timestamp":1676373431000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/186\/2\/195\/6853009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/eje-21-0836","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,1]]}}}