{"id":"473de645136c","type":"article","url":"https://hartvaat.nl/2026/03/26/hoge-cardiometabole-last-bij-bilaterale-macronodulaire-bijnierziekte-met-primair/","title":"Hoge cardiometabole last bij bilaterale macronodulaire bijnierziekte met primair aldosteronisme","title_en":"Cardiometabolic Burden in Bilateral Macronodular Adrenal Disease With Primary Aldosteronism","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","aldosteronsynthaseremmers","baxdrostat","bloeddrukbehandeling","cardio-renaal-metabool","diabetes-en-hart","hypertrofische-cardiomyopathie","lorundrostat","obesitas","resistente-hypertensie","vrouwen"],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25507","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25507","authors":["Annalisa Panarelli"],"significance":5,"published":"2026-03-26","source_date":"2026-03-26","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/hypertensie/hypertensie-en-diabetes/"],"congress":"","summary_en":"Bilateral macronodular adrenocortical disease is often linked to autonomous cortisol secretion but can also present with primary aldosteronism (PA). In this international retrospective cohort (249 patients from 41 centres in 12 countries; median age 55, 62% male), hypertension had been present for a median of 9.9 years at PA diagnosis. Of those tested, 52% had cortisol cosecretion and 47% isolated PA. At baseline, 56% had metabolic comorbidity and 16% had at least one prior major cardiovascular event (MACE); patients with MACE were older, more often male and had longer-standing hypertension. Bilateral macronodular adrenal disease with PA thus carries a substantial cardiometabolic and cardiovascular burden, driven partly by the often long duration of hypertension and frequent cortisol cosecretion.","created":"2026-07-03T10:32:20Z","updated":"2026-07-03T18:39:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Bilaterale macronodulaire bijnierschorsziekte wordt vaak in verband gebracht met autonome cortisolsecretie, maar kan ook gepaard gaan met primair aldosteronisme (PA). In deze internationale retrospectieve cohortstudie (249 patiënten uit 41 centra in 12 landen; mediane leeftijd 55 jaar, 62% man) had de hypertensie bij de PA-diagnose mediaan al 9,9 jaar bestaan. Van de geteste patiënten had 52% cortisolco-secretie en 47% geïsoleerd PA. Bij aanvang had 56% metabole comorbiditeit en 16% minstens één doorgemaakt cardiovasculair event (MACE); patiënten met MACE waren ouder, vaker man en hadden langer bestaande hypertensie. Bilaterale macronodulaire bijnierziekte met PA gaat dus gepaard met een aanzienlijke cardiometabole en cardiovasculaire last, mede door de vaak lange duur van de hypertensie en de frequente cortisolco-secretie.","abstract_original":"Hypertension, Volume 83, Issue 5, Page e25507, May 1, 2026. BACKGROUND:Bilateral macronodular adrenocortical disease is often linked to autonomous cortisol secretion, but may also present with primary aldosteronism (PA).METHODS:This international (Europe, United States, Asia) retrospective cohort study included adults with radiological evidence of bilateral macronodular adrenocortical disease and biochemically confirmed PA. The primary endpoints was major adverse cardiovascular events (MACE); secondary end points included cardiometabolic comorbidities and surgical outcomes per PA surgical outcome criteria.RESULTS:Two hundred forty-nine patients from 41 centers in 12 countries were included (median age, 55 years; 62% male). Median hypertension duration at PA diagnosis was 9.9 years. Among 178 tested, 52% had cortisol cosecretion and 47% isolated PA. At baseline, 56% had metabolic comorbidities, and 16% had ≥1 MACE. Patients with MACE were older, more often male, had longer hypertension "}