{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:40:00Z","timestamp":1790862000061,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Primary aldosteronism (PA) is a leading cause of secondary hypertension, and aldosterone-producing adenoma (APA) is the most prevalent subtype. Surgical intervention is the primary treatment modality. However, a subset of patients fails to achieve normotension postoperatively. The Aldosteronoma Resolution Score (ARS), a preoperative predictive model, was used to forecast postoperative hypertension resolution. This study aims to validate the accuracy of the ARS in predicting hypertension resolution in Asian patients undergoing different surgical approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of 129 patients diagnosed with APA who underwent adrenal surgery. After excluding patients with incomplete data or insufficient follow-up, 83 patients were included in the analysis. Patients were stratified into two groups based on surgical approach: partial adrenalectomy and total adrenalectomy. Clinical and blood pressure data were collected at baseline and 6 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the 6-month follow-up, 62.65% (52\/83) of patients achieved normotension without medication, while 37.35% (31\/83) required continued antihypertensive therapy. Multivariate logistic regression analysis identified that patients achieving complete hypertension resolution were significantly more likely to have: preoperative use of \u22642 antihypertensive medications, hypertension duration \u22646 years, and BMI \u226425 kg\/m\u00b2. The predictive accuracy of the ARS, evaluated using the area under the receiver operating characteristic curve (AUC), was 0.866 for the overall cohort. Among the 49 patients (59.0%) who underwent partial adrenalectomy, 36.73% required antihypertensive medication, with an ARS AUC of 0.839. Among the 34 patients (41.0%) who underwent total adrenalectomy, 61.76% achieved normotension, with an ARS AUC of 0.897. No significant difference was observed in postoperative blood pressure outcomes between the two surgical approaches (<jats:italic>P<\/jats:italic> = 0.889), nor did the surgical approach affect the predictive accuracy of the ARS (<jats:italic>P<\/jats:italic> = 0.461).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study validates the ARS, originally derived from Western populations, as a reliable preoperative predictor of hypertension resolution following adrenalectomy in Asian patients with APA. Furthermore, both partial and total adrenalectomy demonstrated comparable efficacy in achieving blood pressure control. These findings support the broad applicability of the ARS across diverse patient populations and surgical approaches.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1651381","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T04:15:02Z","timestamp":1758255302000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The aldosteronoma resolution score predicts the prognosis of hypertension under two surgical procedures"],"prefix":"10.3389","volume":"16","author":[{"given":"Yifan","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianhao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijie","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoyue","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuedong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"B1","first-page":"3","article-title":"Presidential address. I. Painting background. II. Primary aldosteronism, a new clinical syndrome","volume":"45","author":"Conn","year":"1955","journal-title":"J Lab Clin Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.059","article-title":"Ferri C et\u00a0al: A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients","volume":"48","author":"Rossi","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60834-X","article-title":"Kartali N et\u00a0al: Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study","volume":"371","author":"Douma","year":"2008","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.7326\/M20-0065","article-title":"Williams GH et\u00a0al: The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study","volume":"173","author":"Brown","year":"2020","journal-title":"Ann Intern Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00139","article-title":"The expanding spectrum of primary aldosteronism: implications for diagnosis, pathogenesis, and treatment","volume":"39","author":"Vaidya","year":"2018","journal-title":"Endocr Rev"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30135-3","article-title":"Adolf C et\u00a0al: Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort","volume":"5","author":"Williams","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318165c075","article-title":"Farley DR et\u00a0al: The aldosteronoma resolution score: predicting complete resolution of hypertension after adrenalectomy for aldosteronoma","volume":"247","author":"Zarnegar","year":"2008","journal-title":"Ann Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-05967-y","article-title":"Libutti SK et\u00a0al: Outcomes of Adrenalectomy and the Aldosteronoma Resolution Score in the Black and Hispanic Population","volume":"45","author":"Romero-Velez","year":"2021","journal-title":"World J Surg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.19723\/j.issn.1671-167X.2022.04.017","article-title":"Risk factors of persistent hypertension in primary aldosteronism patients after surgery","volume":"54","author":"Huang-Fu","year":"2022","journal-title":"Beijing Da Xue Xue Bao Yi Xue Ban"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)62886-6","article-title":"Bartsch G et\u00a0al: Laparoscopic surgery for pheochromocytoma: adrenalectomy, partial resection, excision of paragangliomas","volume":"160","author":"Janetschek","year":"1998","journal-title":"J Urol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.111369","article-title":"Porteri E et\u00a0al: Vascular remodeling and duration of hypertension predict outcome of adrenalectomy in primary aldosteronism patients","volume":"51","author":"Rossi","year":"2008","journal-title":"Hypertension"},{"key":"B12","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S2213-8587(17)30319-4","article-title":"Gaita F et\u00a0al: Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis","volume":"6","author":"Monticone","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.123.21474","article-title":"Davio A et\u00a0al: Primary Aldosteronism in Chronic Kidney Disease: Blood Pressure Control and Kidney and Cardiovascular Outcomes After Surgical Versus Medical Management","volume":"80","author":"Cohen","year":"2023","journal-title":"Hypertension"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11568","article-title":"Renal outcomes in medically and surgically treated primary aldosteronism","volume":"72","author":"Hundemer","year":"2018","journal-title":"Hypertension"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2022.04.016","article-title":"Aldosterone, mineralocorticoid receptor activation, and CKD: A review of evolving treatment paradigms","volume":"80","author":"Epstein","year":"2022","journal-title":"Am J Kidney Dis"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061","article-title":"Shibata H et\u00a0al: The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ21-0508","article-title":"Tanabe A et\u00a0al: Japan Endocrine Society clinical practice guideline for the diagnosis and management of primary aldosteronism 2021","volume":"69","author":"Naruse","year":"2022","journal-title":"Endocr J"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00210-2","article-title":"Diagnosis and treatment of primary aldosteronism","volume":"9","author":"Reincke","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.2174\/157016111796642706","article-title":"Smoking and hypertension: independent or additive effects to determining vascular damage","volume":"9","author":"Leone","year":"2011","journal-title":"Curr Vasc Pharmacol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1159\/000501216","article-title":"Laparoscopic partial versus total adrenalectomy in nonhereditary unilateral adrenal masses","volume":"104","author":"Balci","year":"2020","journal-title":"Urol Int"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1089\/end.2014.0102","article-title":"Wu KD et\u00a0al: Clinical outcomes in patients undergoing laparoscopic adrenalectomy for unilateral aldosterone producing adenoma: partial versus total adrenalectomy","volume":"28","author":"Chen","year":"2014","journal-title":"J Endourol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1198519","article-title":"Hypoglycaemia in adrenal insufficiency","volume":"14","author":"Lee","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-595X(86)80021-4","article-title":"Adrenal and gonadal androgen secretion in normal females","volume":"15","author":"Longcope","year":"1986","journal-title":"Clin Endocrinol Metab"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-021-01116-1","article-title":"Partial versus total adrenalectomy for the treatment of unilateral aldosterone-producing adenoma: a systematic review and meta-analysis","volume":"73","author":"Li","year":"2021","journal-title":"Updates Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1651381\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T04:15:04Z","timestamp":1758255304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1651381\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,19]]},"references-count":24,"alternative-id":["10.3389\/fendo.2025.1651381"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1651381","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,19]]},"article-number":"1651381"}}