Document Detail


Resistant hypertension and aldosteronism.
MedLine Citation:
PMID:  18177580     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Resistant hypertension is defined as blood pressure that remains uncontrolled despite using at least three antihypertensive medications in effective doses, ideally including a diuretic. Stricter blood pressure goals, higher obesity rates, older age, and increased use of certain exogenous substances are related to an increasing prevalence of resistant hypertension. The evaluation of patients with resistant hypertension focuses on identifying contributing factors and secondary causes of hypertension including hyperaldosteronism, obstructive sleep apnea, renal artery stenosis, and pheochromocytoma. Hyperaldosteronism is now recognized as the most common secondary cause and all patients with resistant hypertension should be screened with a plasma aldosterone-renin ratio even if the serum potassium level is normal. Treatment includes reversal of contributing factors, appropriate treatment of secondary causes, and use of effective multidrug regimens. Recent studies indicate that the addition of spironolactone to standard treatment regimens induces significant blood pressure reduction in patients with resistant hypertension.
Authors:
Eduardo Pimenta; David A Calhoun
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  9     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-9     Citation Subset:  IM    
Affiliation:
Vascular Biology and Hypertension Program, University of Alabama at Birmingham, 933 19th Street South, Room 115, Birmingham, AL 35294, USA. eduardo.pimenta@ccc.uab.edu
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood
Angiotensin-Converting Enzyme Inhibitors / pharmacology,  therapeutic use
Antihypertensive Agents / pharmacology*,  therapeutic use
Calcium Channel Blockers / pharmacology,  therapeutic use
Drug Resistance
Drug Therapy, Combination
Humans
Hyperaldosteronism / complications*,  diagnosis,  drug therapy*
Hypertension / drug therapy,  etiology*
Hypokalemia / etiology
Renin / blood
Sodium Chloride Symporter Inhibitors / pharmacology,  therapeutic use
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Sodium Chloride Symporter Inhibitors; 52-39-1/Aldosterone; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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