| Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. | |
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MedLine Citation:
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PMID: 20016520 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Obstructive sleep apnoea (OSA) and hyperaldosteronism are very common in subjects with resistant hypertension. We hypothesized that aldosterone-mediated chronic fluid retention may influence OSA severity in patients with resistant hypertension. We tested this in an open-label evaluation by assessing the changes in the severity of OSA in patients with resistant hypertension after treatment with spironolactone. Subjects with resistant hypertension (clinical blood pressure (BP) >or=140/90 mm Hg on >or=3 antihypertensive medications, including a thiazide diuretic and OSA (defined as an apnoea-hypopnoea index (AHI) >or=15) had full diagnostic, polysomnography before and 8 weeks after spironolactone (25-50 mg a day) was added to their ongoing antihypertensive therapy. In all, 12 patients (mean age 56 years and body mass index 36.8 kg m(-2)) were evaluated. After treatment with spironolactone, the AHI (39.8+/-19.5 vs 22.0+/-6.8 events/h; P<0.05) and hypoxic index (13.6+/-10.8 vs 6.7+/-6.6 events/h; P<0.05), weight and clinic and ambulatory BP were significantly reduced. Plasma renin activity (PRA) and serum creatinine were significantly higher. This study provides preliminary evidence that treatment with a mineralocorticoid receptor antagonist substantially reduces the severity of OSA. If confirmed in a randomized assessment, it will support aldosterone-mediated chronic fluid retention as an important mediator of OSA severity in patients with resistant hypertension. |
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Authors:
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K Gaddam; E Pimenta; S J Thomas; S S Cofield; S Oparil; S M Harding; D A Calhoun |
Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural Date: 2009-12-17 |
Journal Detail:
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Title: Journal of human hypertension Volume: 24 ISSN: 1476-5527 ISO Abbreviation: J Hum Hypertens Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-15 Completed Date: 2010-10-22 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 8811625 Medline TA: J Hum Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 532-7 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Diseases, Ochsner Clinic Foundation, New Orleans, LA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure Diuretics / administration & dosage* Drug Resistance Female Follow-Up Studies Humans Hypertension / complications, drug therapy* Male Middle Aged Pilot Projects Polysomnography Severity of Illness Index Sleep Apnea, Obstructive / complications, drug therapy* Spironolactone / administration & dosage* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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M01 RR000032-475160/RR/NCRR NIH HHS; M01-RR00032/RR/NCRR NIH HHS; P50 HL077100/HL/NHLBI NIH HHS; P50 HL077100-050002/HL/NHLBI NIH HHS; R01 HL075614-05/HL/NHLBI NIH HHS; R01-HL79040/HL/NHLBI NIH HHS; T32HL007457/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Diuretics; 52-01-7/Spironolactone |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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