Document Detail


The pharmacological treatment of primary aldosteronism.
MedLine Citation:
PMID:  16553572     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aldosterone is increasingly considered to have a fundamental role in the pathophysiology of cardiovascular disease. Primary aldosteronism is a much more common cause of secondary hypertension than once suspected, accounting for approximately 10% of cases. Screening for primary aldosteronism should be considered even in the presence of normokalaemia. The non-classical effects of aldosterone, some of which are transcription-independent, may be of similar or greater importance than its traditional effects on the kidney. Treatment of primary aldosteronism should be specific and aim to ameliorate all hormone-related effects of aldosterone, not just the most obvious manifestation of hypertension. Mineralocorticoid antagonism, shown to lead to significant additional survival advantage in heart failure, offers the best prospect for achieving therapeutic goals. For the increasing proportion of patients with primary aldosteronism suitable for long-term medical treatment, mineralocorticoid receptor blockade (better tolerated with eplerenone) should be considered the most appropriate choice of treatment, pending the development of better alternatives.
Authors:
Salim Janmohamed; Pierre-Marc G Bouloux
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  7     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-23     Completed Date:  2006-08-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  563-73     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Royal Free Hospital, London, NW3 2QG, UK.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / metabolism
Aldosterone Antagonists / pharmacology,  therapeutic use
Amiloride / pharmacology,  therapeutic use
Calcium Channel Blockers / pharmacology,  therapeutic use
Clinical Trials as Topic
Drug Therapy, Combination
Glucocorticoids / pharmacology,  therapeutic use
Humans
Hyperaldosteronism / complications,  drug therapy*,  metabolism
Hypertension / etiology,  prevention & control
Practice Guidelines as Topic
Receptors, Aldosterone / antagonists & inhibitors,  metabolism
Sodium Channel Blockers / pharmacology,  therapeutic use
Spironolactone / pharmacology,  therapeutic use
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Calcium Channel Blockers; 0/Glucocorticoids; 0/Receptors, Aldosterone; 0/Sodium Channel Blockers; 2609-46-3/Amiloride; 52-01-7/Spironolactone; 52-39-1/Aldosterone

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


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