| Aldosterone excess or escape: Treating resistant hypertension. | |
| | |
MedLine Citation:
|
PMID: 19534021 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Aldosterone excess or "escape" can occur after treatment with medications that block the renin-angiotensin-aldosterone system or in undiagnosed primary aldosteronism. Spironolactone is thought to be an important addition to resistant hypertension (RH) treatment. In this study, resistant (RH) and controlled (CH) hypertensives and normotensive patients were submitted to echocardiography, flow-mediated vasodilation, carotid intima-media wall thickness studies, renin plasma activity, and aldosterone plasma levels and plasma and urinary sodium and potassium concentrations at baseline (pre-spironolactone phase). Subsequently, for only RH and CH groups, 25 mg/d spironolactone was added to preexisting treatments over 6 months. Afterwards, these parameters were reassessed (post-spironolactone phase). The RH and CH groups achieved reductions in blood pressure (P<.001), decreases in left ventricular hypertrophy (P<.001), improved diastolic function (Kappa index RH: 0.219 and Kappa index CH: 0.392) and increases in aldosterone concentrations (P<.05). The RH group attained improved endothelium-dependent (P<.001) and independent (P=.007) function. Optimized RH treatment with spironolactone reduces blood pressure and improves endothelial and diastolic function and left ventricular hypertrophy despite the presence of aldosterone excess or escape. |
| | |
Authors:
|
Samira Ubaid-Girioli; Leoní Adriana de Souza; Juan Carlos Yugar-Toledo; Luiz Cláudio Martins; Sílvia Ferreira-Melo; Otávio Rizzi Coelho; Cristina Sierra; Antonio Coca; Eduardo Pimenta; Heitor Moreno |
Publication Detail:
|
Type: Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of clinical hypertension (Greenwich, Conn.) Volume: 11 ISSN: 1751-7176 ISO Abbreviation: J Clin Hypertens (Greenwich) Publication Date: 2009 May |
Date Detail:
|
Created Date: 2009-06-17 Completed Date: 2009-10-07 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100888554 Medline TA: J Clin Hypertens (Greenwich) Country: United States |
Other Details:
|
Languages: eng Pagination: 245-52 Citation Subset: IM |
Affiliation:
|
Department of Pharmacology, State University of Campinas, SP, Brazil. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aldosterone
/
blood* Aldosterone Antagonists / pharmacology, therapeutic use* Angiotensin II Type 1 Receptor Blockers / pharmacology, therapeutic use Angiotensin-Converting Enzyme Inhibitors / pharmacology, therapeutic use Blood Pressure / drug effects Drug Resistance* Endothelium, Vascular / drug effects Humans Hypertension / blood, drug therapy* Hypertrophy, Left Ventricular / drug therapy Potassium / blood, urine Renin / blood Renin-Angiotensin System / drug effects Sodium / blood, urine Spironolactone / pharmacology, therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Aldosterone Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 7440-09-7/Potassium; 7440-23-5/Sodium; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The effect of ethnicity on the relationship between premature coronary artery disease and traditiona...
Next Document: Uric acid as a marker for renal dysfunction in hypertensive women on diuretic and nondiuretic therap...