| Clinical implications of primary aldosteronism with resistant hypertension. | |
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MedLine Citation:
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PMID: 3346059 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Twenty-eight patients with resistant hypertension were found to have primary aldosteronism; 25 had solitary adenoma and 3 had adrenal hyperplasia. All were severely hypertensive despite receiving three or more antihypertensive agents, including conventional doses of diuretics, sympatholytics, and vasodilators. Hypervolemia (24 patients) or normovolemia (2 patients) despite severe diastolic hypertension was the hallmark in 26 patients. Adequate salt and water depletion alone with spironolactone (200 mg/day) and hydrochlorothiazide (50-100 ng/day) reduced arterial pressure in all. Twenty-two patients had surgical removal of a solitary adenoma. Over 1 to 2 years of follow-up, 13 were normotensive without medication, and six required hydrochlorothiazide and three hydrochlorothiazide plus a beta-blocker to normalize blood pressure. Blood pressure response to surgery had no relation to either duration or severity of hypertension. Six patients (three with hyperplasia, three with adenoma) have continued diuretic therapy and are normokalemic and normotensive. These results indicate that primary aldosteronism can be associated with sever and drug-resistant hypertension, that maintained hypervolemia is the reason for resistance to therapy, that sustained volume depletion is the most important therapeutic goal for these patients, and that cure can be achieved despite prolonged and severe hypertension. |
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Authors:
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E L Bravo; F M Fouad-Tarazi; R C Tarazi; M Pohl; R W Gifford; D G Vidt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hypertension Volume: 11 ISSN: 0194-911X ISO Abbreviation: Hypertension Publication Date: 1988 Feb |
Date Detail:
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Created Date: 1988-04-11 Completed Date: 1988-04-11 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: I207-11 Citation Subset: IM |
Affiliation:
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Research Institute, Cleveland Clinic Foundation, OH 44195. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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complications* Adrenal Gland Neoplasms / complications* Adult Antihypertensive Agents / therapeutic use Diuretics / therapeutic use Female Humans Hyperaldosteronism / complications* Hypertension / drug therapy, etiology* Male Middle Aged Plasma Volume |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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