| Impact of aldosterone receptor blockade compared with thiazide therapy on sympathetic nervous system function in geriatric hypertension. | |
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MedLine Citation:
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PMID: 20368505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Aldosterone receptor blockade and thiazide therapy effectively lower blood pressure in geriatric hypertension. Their impact on sympathetic nervous system function has not been evaluated. In a double-blind, randomized study, 36 patients with stage 1 hypertension underwent 6 months of therapy with either aldosterone receptor blockade (spironolactone, n=19; 68+/-1 years) or hydrochlorothiazide (n=17; 68+/-2 years). Arterial blood pressure, [(3)H]-norepinephrine (NE) kinetics (extravascular NE release rate), and alpha-adrenergic responsiveness (forearm vasoconstriction to graded intrabrachial artery NE infusions) were evaluated at baseline, after a 4-week antihypertensive medication withdrawal, and after spironolactone or hydrochlorothiazide treatment. Arterial blood pressure decreased significantly with both spironolactone (160+/-3 to 134+/-2 mm Hg; 77+/-2 to 68+/-2 mm Hg) and hydrochlorothiazide (161+/-4 to 145+/-4 mm Hg; 78+/-2 to 73+/-2 mm Hg) treatment. Sympathetic nervous system activity was significantly reduced after spironolactone (plasma NE: 378+/-40 to 335+/-20 pg/mL, P=0.04; [(3)H]-NE release rate: 2.74+/-0.3 to 1.97+/-0.2 microg/min per meter squared, P=0.04) but not hydrochlorothiazide (plasma NE: 368+/-25 to 349+/-23 pg/mL, P=0.47; [(3)H]-NE release rate: 2.63+/-0.4 to 2.11+/-0.2 mg/min per meter squared, P=0.21). alpha-Adrenergic responsiveness was unchanged with either drug treatment. These findings demonstrate a beneficial effect of aldosterone receptor blockade on reducing sympathetic nervous system activity and blood pressure in hypertensive older patients. |
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Authors:
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D Walter Wray; Mark A Supiano |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2010-04-05 |
Journal Detail:
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Title: Hypertension Volume: 55 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-15 Completed Date: 2010-05-28 Revised Date: 2012-10-09 |
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: 1217-23 Citation Subset: IM |
Affiliation:
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Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, UT 84132, USA. walter.wray@hsc.utah.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aldosterone / blood Aldosterone Antagonists / therapeutic use* Blood Pressure / drug effects* Body Composition Catecholamines / blood Diuretics / therapeutic use Female Heart Rate / drug effects Humans Hydrochlorothiazide / therapeutic use* Hypertension / blood, drug therapy, physiopathology* Lipoproteins, HDL / blood Lipoproteins, LDL / blood Male Middle Aged Norepinephrine / blood Patient Selection Receptors, Aldosterone / antagonists & inhibitors* Spironolactone / therapeutic use* Sympathetic Nervous System / drug effects, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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K07 AG 28403/AG/NIA NIH HHS; K07 AG028403-01A1/AG/NIA NIH HHS; K07 AG028403-05/AG/NIA NIH HHS; K24 AG000924-01/AG/NIA NIH HHS; M01-RR00042/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Aldosterone Antagonists; 0/Catecholamines; 0/Diuretics; 0/Lipoproteins, HDL; 0/Lipoproteins, LDL; 0/Receptors, Aldosterone; 51-41-2/Norepinephrine; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 58-93-5/Hydrochlorothiazide |
| Comments/Corrections | |
Comment In:
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Hypertension. 2010 May;55(5):1090-1
[PMID:
20368501
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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