| Menopause not aldosterone-to-renin ratio predicts blood pressure response to a mineralocorticoid receptor antagonist in primary care hypertensive patients. | |
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MedLine Citation:
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PMID: 18600211 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It has been suggested that hypertensive patients with raised aldosterone-to-renin ratio (ARR) are specifically sensitive to mineralocorticoid receptor antagonists (MRAs). We have previously shown that patients with an elevated ARR are relatively frequent in the setting of primary care. We therefore designed an interventional study to ascertain whether primary care hypertensive patients with an elevated ARR presented a superior response to MRA treatment than subjects with normal ratio. METHODS: According to the previously observed distribution in general population, 1/3 and 2/3 of hypertensive patients with high or normal ARR, respectively, were treated with kanrenoate 50-100 mg/day for 2 months. To avoid uncontrolled blood pressure (BP), 49% of patients continued also "ARR-neutral" drugs such as verapamil and/or alpha-adrenergic blockers. Patients groups were matched for most features but an elevated ARR was more frequent in female than in male gender; moreover, 90% of women with raised ARR were in menopause. RESULTS: A clear reduction of BP values was recorded after both the first and the second month of treatment with kanrenoate, with the maximal effect obtained when the dosage titration at 100 mg/day was accomplished. However, patients previously identified by a raised ARR did not have a larger response to MRA treatment than patients with normal ratio. In contrast, MRA was twofold more effective in reducing SBP in women than in men (after 2 months of treatment -16.4 mm Hg vs.-8.2 mm Hg). CONCLUSIONS: These results suggest that postmenopausal hypertension is largely dependent on mineralocorticoid receptor activation and selectively sensitive to MRAs. |
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Authors:
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Oliviero Olivieri; Francesca Pizzolo; Alberto Ciacciarelli; Roberto Corrocher; Denise Signorelli; Salvatore Falcone; Gian S Blengio |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-07-03 |
Journal Detail:
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Title: American journal of hypertension Volume: 21 ISSN: 0895-7061 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-26 Completed Date: 2009-01-07 Revised Date: 2009-02-24 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 976-82 Citation Subset: IM |
Affiliation:
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Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Verona, Italy. oliviero.olivieri@univr.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Antagonists
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pharmacology Adult Aged Aldosterone / blood* Blood Pressure / drug effects* Canrenoate Potassium / pharmacology Female Humans Hypertension / physiopathology* Male Menopause / physiology* Middle Aged Receptors, Mineralocorticoid / antagonists & inhibitors*, physiology Renin / blood* Verapamil / pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Antagonists; 0/Receptors, Mineralocorticoid; 2181-04-6/Canrenoate Potassium; 52-39-1/Aldosterone; 52-53-9/Verapamil; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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