AIM: Clinically, patients with adrenal tumors are prone to secondary hypertension. This study aimed to identify key factors influencing the antihypertensive effect of surgery by retrospectively analyzing clinical data from patients with adrenal tumors complicated by hypertension, to provide a reference for clinical prognosis evaluation, guide individualized treatment planning, and improve treatment success rates.

METHODS: A total of 82 patients diagnosed with adrenal tumors by imaging and complicated by hypertension were included, and all underwent laparoscopic adrenal tumor resection. According to the antihypertensive effect at 6 months postoperatively, patients were divided into an effective antihypertensive group and an ineffective antihypertensive group. Clinical data of both groups were collected. Univariate analysis was performed to screen differential variables, and variables with statistical significance were included in a multivariate logistic regression model to identify independent factors affecting the short-term surgical antihypertensive effect.

RESULTS: No significant differences were observed between the two groups in age, gender, other general characteristics, or perioperative indicators of laparoscopic surgery (operative time, intraoperative blood loss, postoperative hospital stay, and complication rate) (p > 0.05). Univariate analysis showed significant differences between the two groups in hypertension disease course, tumor pathological type, preoperative systolic blood pressure (SBP) level, preoperative aldosterone/norepinephrine levels, and tumor maximum diameter (p < 0.05). Multivariate logistic regression analysis showed that hypertension duration ≥6 years, non-functional adenoma, and preoperative SBP ≥170 mmHg were independent factors affecting the surgical antihypertensive effect (p < 0.05).

CONCLUSIONS: Laparoscopic surgery is an effective treatment for adrenal tumors complicated by hypertension. However, patients with long-term hypertension, non-functional adenoma, and markedly elevated preoperative SBP may experience a poor short-term postoperative antihypertensive effect.