| Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. | |
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MedLine Citation:
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PMID: 10221346 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is increasing evidence for important cardiovascular effects of aldosterone via classical mineralocorticoid receptors in the heart. Administration of aldosterone with excess salt produces both cardiac hypertrophy and interstitial cardiac fibrosis in rats, and concomitant administration of potassium canrenoate at a dose that only modestly lowers blood pressure completely blocks the cardiac effects of aldosterone. In the present study, we examined the effect on left ventricular hypertrophy of adding a low dose of the mineralocorticoid receptor antagonist spironolactone (25 mg/d) to an angiotensin-converting enzyme inhibitor (enalapril maleate) in patients with essential hypertension. Eighteen untreated patients with moderate to severe essential hypertension based on the WHO/ISH guidelines participated in this study. Subjects were treated with either an angiotensin-converting enzyme inhibitor alone (group I: 10 patients, 4 men and 6 women, mean age 56 +/- 18 yr) or an angiotensin-converting enzyme inhibitor plus spironolactone (group II: 8 patients, 3 men and 5 women, mean age 59 +/- 14 yr) for 9 mo. Left ventricular mass index, various echocardiographic variables, mean blood pressure, plasma renin activity, and plasma aldosterone concentration before treatment were similar in the two groups. Blood pressure of both groups decreased significantly and similarly after antihypertensive treatment (group I, 136 +/- 9/82 +/- 9 mmHg; group II, 133 +/- 9/85 +/- 10 mmHg). Left ventricular mass index also decreased significantly in both groups (group I, -10.2 +/- 7.1%; group II, -18.1 +/- 6.9%). The extent of reduction was significantly greater in the spironolactone group (group II) (p < 0.05 vs. group I). In group II patients, spironolactone did not cause any side effects during the observation period. We conclude that spironolactone may have beneficial effects on left ventricular hypertrophy in patients with essential hypertension who are receiving an angiotensin-converting enzyme inhibitor. |
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Authors:
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A Sato; Y Suzuki; T Saruta |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article |
Journal Detail:
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Title: Hypertension research : official journal of the Japanese Society of Hypertension Volume: 22 ISSN: 0916-9636 ISO Abbreviation: Hypertens. Res. Publication Date: 1999 Mar |
Date Detail:
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Created Date: 1999-06-24 Completed Date: 1999-06-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9307690 Medline TA: Hypertens Res Country: JAPAN |
Other Details:
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Languages: eng Pagination: 17-22 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Mito Red Cross Hospital, Ibaraki, Japan. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aldosterone
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blood Aldosterone Antagonists / therapeutic use* Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Blood Pressure / drug effects Drug Therapy, Combination Echocardiography Enalapril / therapeutic use* Female Follow-Up Studies Heart Rate / drug effects Heart Ventricles / drug effects, ultrasonography Humans Hypertension / blood, complications, drug therapy* Hypertrophy, Left Ventricular / blood, drug therapy*, etiology Male Middle Aged Radioimmunoassay Renin / blood Spironolactone / therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Aldosterone Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 75847-73-3/Enalapril; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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