Improvement in Quality of Life and Psychological Symptoms After Treatment for Primary Aldosteronism

Background: Primary aldosteronism (PA) is the most common treatable cause of secondary hypertension. In addition to increased cardiovascular risk, patients also suffer from impaired quality of life (QoL) and psychological symptoms. We assessed for changes in QoL and depressive symptoms in a cohort of Asian patients with PA, after surgical and medical therapy. Methods: We administered questionnaires to 34 patients with PA, mean age, 51.3 years, 29.4% females, in a prospective observational study from 2017 to 2020. QoL was assessed using RAND-36 and EQ-5D-3L, and depressive symptoms was assessed using Beck Depression Inventory (BDI-II) at baseline, 6 months, and 1 year post-treatment. Results: Significant improvement was observed 1 year after treatment in both physical and mental summative scores of RAND-36 from baseline, +3.65 (p = 0.023) and +3.41 (p = 0.033) respectively, as well as four subscale domains (physical functioning, bodily pain, role emotional and mental health). Significant improvement was also seen in EQ-5D dimension of anxiety/depression at 1 year post-treatment. Patients treated with surgery (N=21) had significant improvement in EQ-5D index score post-treatment, and better EQ-5D outcomes compared to medical group (N=13) at 1 year post-treatment. 37.9%, 41.6% and 60.7% of patients had symptoms in the cognitive, affective and somatic domains of the BDI-II respectively. There was significant improvement in the affective domain of BDI after 1 year of treatment. Conclusion: Appropriate treatment with surgical and medical therapy improves QoL and psychological symptoms in patients with PA, highlighting the importance of early diagnosis and treatment of this common condition.