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This work was funded by Sociedad Espanola de Endocrinologia y Nutricion (SEEN) https://www.seen.es/portal.

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Differences in the presentation and evolution of primary aldosteronism in elderly (≥65 years) and young patients (<65 years)

Publicado en:Endocrine Connections. 11 (6): EC-0169 - 2022-06-01 11(6), DOI: 10.1530/ec-22-0169

Autores: Parra Ramirez, Paola; Martin Rojas-Marcos, Patricia; Paja Fano, Miguel; Gonzalez Boillos, Marga; Pascual-Corrales, Eider; Garcia-Cano, Ana; Gabriel Ruiz-Sanchez, Jorge; Vicente, Almudena; Gomez-Hoyos, Emilia; Ferreira, Rui; Garcia Sanz, Inigo; Recasens, Monica; Pla Peris, Begona; Barahona San Millan, Rebeca; Picon Cesar, Maria Jose; Diaz Guardiola, Patricia; Garcia Gonzalez, Juan Jesus; Perdomo, Carolina; Manjon, Laura; Garcia-Centeno, Rogelio; Carlos Percovich, Juan; Rebollo Roman, Angel; Gracia Gimeno, Paola; Robles Lazaro, Cristina; Morales, Manuel; Hanzu, Felicia; Araujo-Castro, Marta

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Objective: To compare the presentation and evolution of primary aldosteronism (PA) in the elderly (?65 years) and young patients (<65 years). Methods: A retrospective multicenter study was performed in 20 Spanish hospitals of PA patients in follow-up between 2018 and 2021. Results: Three hundred fifty-two patients with PA <65 years and 88 patients ?65 years were included. Older PA patients had a two-fold higher prevalence of type 2 diabetes, dyslipidemia, and cerebrovascular disease, but these differences disappeared after adjusting for hypertension duration. At diagnosis, diastolic blood pressure was lower than in young patients (83.3 ± 11.54 vs 91.6 ± 14.46 mmHg, P < 0.0001). No differences in the rate of overall correct cannulation (56.5% vs 42.3%, P = 0.206) or the diagnosis of unilaterality (76.9% vs 62.5%, P = 0.325) in the adrenal venous sampling (AVS) was observed between the elderly and young groups. However, there was a lower proportion of PA patients who underwent adrenalectomy in the elderly group than in the younger group (22.7% (n = 20) vs 37.5% (n = 132), P = 0.009). Nevertheless, no differences in the rate of postsurgical biochemical (100% (n = 14) vs 92.8% (n = 90), P = 0.299) and hypertension cure (38.6% (n = 51) vs 25.0% (n = 5), P = 0.239) were observed between both groups. Conclusion: Older patients with PA have a worse cardiometabolic profile than young patients with PA that it is related to a longer duration of hypertension. However, the results of the AVS, and adrenalectomy are similar in both groups. Therefore, the management of elderly patients with PA should be based not only on age, but rather on the overall medical, physical, social, and mental characteristics of the patients. © 2022 The authors Published by Bioscientifica Ltd.

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