Document Detail


Aldosterone antagonism: an emerging strategy for effective blood pressure lowering.
MedLine Citation:
PMID:  15913492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aldosterone antagonists have been available for many decades for the treatment of hypertension, but their use has been mostly limited to patients with classic primary aldosteronism or to combination products with hydrochlorothiazide to minimize risk for hypokalemia. Recently, indications for aldosterone antagonists have been expanded to include congestive heart failure and first-line treatment of mild-to-moderate hypertension. In addition, we have reported that spironolactone has significant antihypertensive benefit when added to existing regimens in patients with resistant hypertension. This benefit was present in patients with and without hyperaldosteronism and was additive to chronic renin-angiotensin blockade with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). Eplerenone, a selective aldosterone antagonist, avoids the androgen and progesterone receptor-related adverse events that sometimes occur with spironolactone, such as breast tenderness, gynecomastia, sexual dysfunction, and menstrual irregularities. In clinical trials, eplerenone has been shown to have antihypertensive benefit in treating mild-to-moderate hypertension similar to other widely used classes of agents. With recent demonstrations of benefit in multiple segments of the hypertensive population, aldosterone antagonists represent emerging opportunity for controlling high blood pressure.
Authors:
Monique N Pratt-Ubunama; Mari K Nishizaka; David A Calhoun
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  7     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-05-25     Completed Date:  2006-01-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  186-92     Citation Subset:  IM    
Affiliation:
Vascular Biology and Hypertension Program, University of Alabama at Birmingham, 933 19th Street South, Room 115, Birmingham, AL 35294, USA. mprattmd@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Aldosterone Antagonists / therapeutic use*
Humans
Hyperaldosteronism / complications*
Hypertension / drug therapy*,  etiology
Spironolactone / analogs & derivatives*,  therapeutic use
Grant Support
ID/Acronym/Agency:
HL07457/HL/NHLBI NIH HHS; HL075614/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/eplerenone; 52-01-7/Spironolactone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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