Document Detail


Aldosterone and refractory hypertension.
MedLine Citation:
PMID:  17940442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Evidence from clinical trials suggests that refractory hypertension is increasingly common. The underlying mechanisms are largely unknown but recent data have implicated increased aldosterone activity as an important mediator of resistance to routinely used antihypertensive agents. RECENT FINDINGS: Epidemiological studies have suggested a significant rise in the prevalence of primary aldosteronism among patients with hypertension. This reflects the increasing use of an aldosterone-to-renin ratio as a screening tool. Recent reports have demonstrated that relative aldosterone excess is common in individuals with refractory hypertension, and that the use of aldosterone antagonists leads to better blood pressure control in such patients. SUMMARY: These data highlight the potential role of aldosterone in the pathogenesis of hypertension. The syndrome of primary aldosteronism, however, encompasses a wide spectrum of disorders that will require better definition. Similarly, although aldosterone blockade is apparently beneficial in individuals with refractory hypertension, this evidence is not currently based on robust randomized, double-blind trial.
Authors:
Moffat J Nyirenda; Paul L Padfield
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in endocrinology, diabetes, and obesity     Volume:  14     ISSN:  1752-2978     ISO Abbreviation:  -     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-10-17     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308636     Medline TA:  Curr Opin Endocrinol Diabetes Obes     Country:  England    
Other Details:
Languages:  eng     Pagination:  213-8     Citation Subset:  IM    
Affiliation:
Endocrinology Unit, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / metabolism*
Aldosterone Antagonists / therapeutic use
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Drug Resistance
Humans
Hyperaldosteronism / complications,  epidemiology
Hypertension / complications,  drug therapy*,  etiology,  physiopathology*
Incidence
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Antihypertensive Agents; 52-39-1/Aldosterone

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


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