The prognosis of
hypertension was evaluated pre-operatively in 40 patients with primary
aldosteronism owing to
adenoma by examining the severity of
hypertension, family history of
hypertension, age of the patients, duration of
hypertension, plasma
renin activity, plasma
aldosterone concentration, and efficacy of
spironolactone (100 mg per day for 10 days) on blood pressure. In 30 of the 40 patients, the blood pressure was reduced to below 160/95 mmHg within a year after
adrenalectomy (responders). In the other 10 patients, the blood pressure was not markedly reduced and remained above 160/95 mmHg (nonresponders). There were no significant differences in the age of the patients, family history of
hypertension, plasma
renin activity or plasma
aldosterone concentration between these two groups. The severity of
hypertension as judged by the WHO classification and the duration of
hypertension prior to operation seemed to be of some use in assessing the postoperative prognosis of
hypertension, but the efficacy of
spironolactone was far more useful. That is to say, a reduction in mean blood pressure of more than 15 mmHg after administration of
spironolactone was observed in 29 of the 30 responders. The remaining one patient showed an 11 mmHg reduction in mean blood pressure. On the other hand, none of the nonresponders revealed a reduction in mean blood pressure of more than 15 mmHg after
spironolactone administration. From these results it is concluded that the pre-operative response of blood pressure to administration of 100 mg per day of
spironolactone for 10 days represents a useful
indicator of the postoperative prognosis of
hypertension in patients with primary
aldosteronism owing to
adenoma.