Horm Metab Res 2017; 49(12): 943-950
DOI: 10.1055/s-0043-121706
Review
© Georg Thieme Verlag KG Stuttgart · New York

Health-Related Quality of Life and Mental Health in Primary Aldosteronism: A Systematic Review

Marieke S. Velema
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Aline H. de Nooijer
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Vivian W. G. Burgers
2   Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Ad. R. M. M. Hermus
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Henri J. L. M. Timmers
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
,
Jacques W. M. Lenders
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
3   Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technical University Dresden, Dresden, Germany
,
Olga Husson
2   Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
,
Jaap Deinum
1   Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
› Author Affiliations
Further Information

Publication History

received 09 August 2017

accepted 12 October 2017

Publication Date:
04 December 2017 (online)

Abstract

The aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Second, the selected studies were systematically reviewed and checked for our predefined inclusion criteria. The search yielded 753 articles, of which 15 studies met our inclusion criteria. Untreated patients with primary aldosteronism showed an impaired physical and mental HRQoL as compared to the general population. Multiple domains of HRQoL were affected. This applied to patients with both an aldosterone-producing adenoma and bilateral adrenal hyperplasia. Adrenalectomy improves HRQoL. Conflicting results have been reported on the extent of this improvement, the improvement after initiation of medical treatment, and whether there is a difference in HRQoL after both treatments. Similarly, psychopathological symptoms of anxiety, demoralization, stress, depression and nervousness were more frequently reported in untreated patients with primary aldosteronism than in the general population and patients with hypertension. Also an impaired sleep quality has been reported. Improvement of these symptoms was observed after treatment with both adrenalectomy and mineralocorticoid receptor antagonists. This review shows that HRQoL is impaired and psychopathology is more frequently reported in patients with primary aldosteronism. This seems to be at least partly reversible after treatment but the extent of improvement remains unknown. To assess HRQoL in these patients more precisely a primary aldosteronism-specific HRQoL questionnaire is required.

Supplementary Material

 
  • References

  • 1 Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, Stowasser M, Young Jr. WF. The management of primary aldosteronism: Case detection, diagnosis, and treatment: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016; jc20154061
  • 2 Catena C, Colussi G, Lapenna R, Nadalini E, Chiuch A, Gianfagna P, Sechi LA. Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918
  • 3 Hartmann I, Grepl M, Vidlar A, Smakal O, Vaclavik J, Frysak Z, Dolezel M, Student V. Outcomes of adrenalectomy in patients with primary hyperaldosteronism–a single centre experience. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014; 158: 583-590
  • 4 Volpe C, Hamberger B, Hoog A, Mukai K, Calissendorff J, Wahrenberg H, Zedenius J, Thoren M. Primary aldosteronism: Functional histopathology and long-term follow-up after unilateral adrenalectomy. Clin Endocrinol (Oxf) 2015; 82: 639-647
  • 5 Wachtel H, Cerullo I, Bartlett EK, Kelz RR, Cohen DL, Karakousis GC, Roses RE, Fraker DL. Long-term blood pressure control in patients undergoing adrenalectomy for primary hyperaldosteronism. Surgery 2014; 156: 1394-1402
  • 6 Lim PO, Young WF, MacDonald TM. A review of the medical treatment of primary aldosteronism. J Hypertens 2001; 19: 353-361
  • 7 Ahmed AH, Gordon RD, Sukor N, Pimenta E, Stowasser M. Quality of life in patients with bilateral primary aldosteronism before and during treatment with spironolactone and/or amiloride, including a comparison with our previously published results in those with unilateral disease treated surgically. J Clin Endocrinol Metab 2011; 96: 2904-2911
  • 8 Sukor N, Kogovsek C, Gordon RD, Robson D, Stowasser M. Improved quality of life, blood pressure, and biochemical status following laparoscopic adrenalectomy for unilateral primary aldosteronism. J Clin Endocrinol Metab 2010; 95: 1360-1364
  • 9 Sonino N, Fallo F, Fava GA. Psychological aspects of primary aldosteronism. Psychother Psychosom 2006; 75: 327-330
  • 10 Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med 2009; 151: 264-269 w264
  • 11 Altman DG. Systematic reviews of evaluations of prognostic variables. BMJ 2001; 323: 224-228
  • 12 Institute TJB. Joanna Briggs Institute Reviewers' Manual: 2016 edition. Australia: The Joanna Briggs Institute; 2016;
  • 13 Citton M, Iacobone M, Viel G, Rossi GP. 0023: Unilateral adrenalectomy for lateralized primary aldosteronism improves the mental health and the depression score at one month. High Blood Pressure Cardiovasc Prevent 2016; 23: 60
  • 14 Kawasaki Y, Kaiho Y, Izumi H, Kawamorita N, Yamashita S, Adachi H, Mitsuzuka K, Ito A, Ishidoya S, Arai Y. Short-term impact on health-related quality of life of laparoscopic adrenalectomy for primary aldosteronism in japanese patients. J Urol 2017; 197 4 Supplement 1 e483
  • 15 Tsuchimochi S, Nakajo M, Nakajo M, Tanabe H, Umanodan T, Nakabeppu Y. Comparison of cerebral blood flow and mental states before and after therapy in primary aldosteronism. Eur J Nucl Med 2001; 28: 1216-1216
  • 16 Christakis I, Livesey JA, Sadler GP, Mihai R. Laparoscopic adrenalectomy for conn's syndrome is beneficial to patients and is cost effective in England. J Invest Surg 2017; 1-7
  • 17 Hanusch FM, Fischer E, Lang K, Diederich S, Endres S, Allolio B, Beuschlein F, Reincke M, Quinkler M. Sleep quality in patients with primary aldosteronism. Hormones (Athens) 2014; 13: 57-64
  • 18 Kunzel HE, Apostolopoulou K, Pallauf A, Gerum S, Merkle K, Schulz S, Fischer E, Brand V, Bidlingmaier M, Endres S, Beuschlein F, Reincke M. Quality of life in patients with primary aldosteronism: Gender differences in untreated and long-term treated patients and associations with treatment and aldosterone. J Psychiatr Res 2012; 46: 1650-1654
  • 19 Sonino N, Tomba E, Genesia ML, Bertello C, Mulatero P, Veglio F, Fava GA, Fallo F. Psychological assessment of primary aldosteronism: a controlled study. J Clin Endocrinol Metab 2011; 96: E878-E883
  • 20 Apostolopoulou K, Kunzel HE, Gerum S, Merkle K, Schulz S, Fischer E, Pallauf A, Brand V, Bidlingmaier M, Endres S, Beuschlein F, Reincke M. Gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism: A cross-sectional study. World J Biol Psychiatr 2014; 15: 26-35
  • 21 Dekkers T, Prejbisz A, Kool LJ, Groenewoud HJ, Velema M, Spiering W, Kolodziejczyk-Kruk S, Arntz M, Kadziela J, Langenhuijsen JF, Kerstens MN, van den Meiracker AH, van den Born BJ, Sweep FC, Hermus AR, Januszewicz A, Ligthart-Naber AF, Makai P, van der Wilt GJ, Lenders JW, Deinum J. Investigators S. Adrenal vein sampling versus CT scan to determine treatment in primary aldosteronism: An outcome-based randomised diagnostic trial. Lancet Diabetes Endocrinol 2016; 4: 739-746
  • 22 Houlihan DJ. Episodic rage associated with primary aldosteronism resolved with adrenalectomy. Psychother Psychosom 2011; 80: 306-307
  • 23 Khurshid KA, Weaver ME. Conn's syndrome presenting as depression. Am J Psychiatry 2005; 162: 1226
  • 24 Malinow KC, Lion JR. Hyperaldosteronism (Conn's disease) presenting as depression. J Clin Psychiatry 1979; 40: 358-359
  • 25 Born-Frontsberg E, Reincke M, Rump LC, Hahner S, Diederich S, Lorenz R, Allolio B, Seufert J, Schirpenbach C, Beuschlein F, Bidlingmaier M, Endres S, Quinkler M. Participants of the German Conn's R. Cardiovascular and cerebrovascular comorbidities of hypokalemic and normokalemic primary aldosteronism: results of the German Conn's Registry. J Clin Endocrinol Metab 2009; 94: 1125-1130
  • 26 Milliez P, Girerd X, Plouin PF, Blacher J, Safar ME, Mourad JJ. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol 2005; 45: 1243-1248
  • 27 Andela CD, Scharloo M, Ramondt S, Tiemensma J, Husson O, Llahana S, Pereira AM, Kaptein AA, Kamminga NG, Biermasz NR. The development and validation of the Leiden Bother and Needs Questionnaire for patients with pituitary disease: the LBNQ-Pituitary. Pituitary 2016; 19: 293-302
  • 28 Milian M, Teufel P, Honegger J, Gallwitz B, Schnauder G, Psaras T. The development of the Tuebingen Cushing's disease quality of life inventory (Tuebingen CD-25). Part II: Normative data from 1784 healthy people. Clin Endocrinol (Oxf) 2012; 76: 861-867
  • 29 Webb SM, Prieto L, Badia X, Albareda M, Catala M, Gaztambide S, Lucas T, Paramo C, Pico A, Lucas A, Halperin I, Obiols G, Astorga R. Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol (Oxf) 2002; 57: 251-258
  • 30 Webb SM, Puig-Domingo M, Villabona C, Munoz-Torres M, Farrerons J, Badia X. Development of a new tool for assessing health-related quality of life in patients with primary hyperparathyroidism. Health Qual Life Outcomes 2013; 11: 97
  • 31 Johnson C, Aaronson NK, Blazeby JM, Bottomley A, Fayers P, Michael K, Kulis D, Ramage J, Sprangers MA, Velikova G, Young T. Guidelines for Developing Questionnaire Modules. In: Group EQoL, ed 2011;
  • 32 Hasler G. Well-Being: An important concept for psychotherapy and psychiatric neuroscience. Psychother Psychosom 2016; 85: 255-261
  • 33 Bech P. Clinimetric dilemmas in outcome scales for mental disorders. Psychother Psychosom 2016; 85: 323-326
  • 34 Pratt-Ubunama MN, Nishizaka MK, Boedefeld RL, Cofield SS, Harding SM, Calhoun DA. Plasma aldosterone is related to severity of obstructive sleep apnea in subjects with resistant hypertension. Chest 2007; 131: 453-459
  • 35 Agarwal MK, Mirshahi F, Mirshahi M, Rostene W. Immunochemical detection of the mineralocorticoid receptor in rat brain. Neuroendocrinology 1993; 58: 575-580
  • 36 MacKenzie SM, Lai M, Clark CJ, Fraser R, Gomez-Sanchez CE, Seckl JR, Connell JM, Davies E. 11beta-hydroxylase and aldosterone synthase expression in fetal rat hippocampal neurons. J Mol Endocrinol 2002; 29: 319-325
  • 37 Geerling JC, Loewy AD. Aldosterone in the brain. Am J Physiol Renal Physiol 2009; 297: F559-F576
  • 38 Hlavacova N, Jezova D. Chronic treatment with the mineralocorticoid hormone aldosterone results in increased anxiety-like behavior. Horm Behav 2008; 54: 90-97
  • 39 Hlavacova N, Bakos J, Jezova D. Eplerenone, a selective mineralocorticoid receptor blocker, exerts anxiolytic effects accompanied by changes in stress hormone release. J Psychopharmacol 2010; 24: 779-786
  • 40 Gard PR. Angiotensin as a target for the treatment of Alzheimer's disease, anxiety and depression. Expert Opin Ther Targets 2004; 8: 7-14
  • 41 Saavedra JM, Ando H, Armando I, Baiardi G, Bregonzio C, Juorio A, Macova M. Anti-stress and anti-anxiety effects of centrally acting angiotensin II AT1 receptor antagonists. Regul Pept 2005; 128: 227-238
  • 42 Lainscak M, Pelliccia F, Rosano G, Vitale C, Schiariti M, Greco C, Speziale G, Gaudio C. Safety profile of mineralocorticoid receptor antagonists: Spironolactone and eplerenone. Int J Cardiol 2015; 200: 25-29
  • 43 De Graaf R, ten Have M, van Gool C, van Dorsselaer S. Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands Mental Health Survey and Incidence Study-2. Soc Psychiatry Psychiatr Epidemiol 2012; 47: 203-213