Document Detail


Aldosteronism and resistant hypertension.
MedLine Citation:
PMID:  21331160     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Resistant hypertension (RHTN) is defined as blood pressure (BP) that remains uncontrolled in spite of intake of ≥3 antihypertensive medications, ideally prescribed at optimal doses and one of which is a diuretic. The incidence of primary aldosteronism (PA) in patients with RHTN is estimated in prospective studies to be 14 to 23%, which is higher than in the general hypertensive population. Patients with PA are at an increased cardiovascular risk, as shown by higher rates of stroke, myocardial infarction, and arrhythmias compared to hypertensive individuals without PA. Likewise, RHTN is associated with adverse cardiovascular outcomes, and the contribution of PA to this increased risk is undetermined. Similar to PA, obstructive sleep apnea (OSA) is closely associated with RHTN, and a causal link between PA, OSA, and RHTN remains to be elucidated. The addition of MR antagonists to the antihypertensive regimen in patients with RHTN produces a profound BP-lowering effect, and this effect is seen in patients with or without biochemical evidence of PA, highlighting the role of relative aldosterone excess in driving treatment resistance in this group of patients.
Authors:
Maria Czarina Acelajado; David A Calhoun
Publication Detail:
Type:  Journal Article     Date:  2011-01-20
Journal Detail:
Title:  International journal of hypertension     Volume:  2011     ISSN:  2090-0392     ISO Abbreviation:  Int J Hypertens     Publication Date:  2011  
Date Detail:
Created Date:  2011-02-18     Completed Date:  2011-07-14     Revised Date:  2011-07-25    
Medline Journal Info:
Nlm Unique ID:  101538881     Medline TA:  Int J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  837817     Citation Subset:  -    
Affiliation:
Vascular Biology and Hypertension Program, University of Alabama at Birmingham, CH19, Room 115, 1530 3rd Avenue South, Birmingham, AL 35294-2041, USA.
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