Aldosterone excess or escape: Treating resistant hypertension

Ubaid-Girioli, Samira, de Souza, Leoní Adriana, Yugar-Toledo, Juan Carlos, Martins, Luiz Cláudio, Ferreira-Melo, Sílvia, Coelho, Otávio Rizzi, Sierra, Cristina, Coca, Antonio, Pimenta, Eduardo and Moreno, Heitor (2009) Aldosterone excess or escape: Treating resistant hypertension. The Journal of Clinical Hypertension, 11 5: 245-252. doi:10.1111/j.1751-7176.2009.00110.x


Author Ubaid-Girioli, Samira
de Souza, Leoní Adriana
Yugar-Toledo, Juan Carlos
Martins, Luiz Cláudio
Ferreira-Melo, Sílvia
Coelho, Otávio Rizzi
Sierra, Cristina
Coca, Antonio
Pimenta, Eduardo
Moreno, Heitor
Title Aldosterone excess or escape: Treating resistant hypertension
Journal name The Journal of Clinical Hypertension   Check publisher's open access policy
ISSN 1524-6175
1751-7176
Publication date 2009-05
Sub-type Article (original research)
DOI 10.1111/j.1751-7176.2009.00110.x
Volume 11
Issue 5
Start page 245
End page 252
Total pages 8
Place of publication Hoboken, NJ, United States
Publisher Le Jacq Communications
Language eng
Subject 1103 Clinical Sciences
Abstract Aldosterone excess or "escape" can occur after treatment with medications that block the renin-angiotensin-aldosterone system or in undiagnosed primary aldosteronism. Spironolactone is thought to be an important addition to resistant hypertension (RH) treatment. In this study, resistant (RH) and controlled (CH) hypertensives and normotensive patients were submitted to echocardiography, flow-mediated vasodilation, carotid intima-media wall thickness studies, renin plasma activity, and aldosterone plasma levels and plasma and urinary sodium and potassium concentrations at baseline (pre-spironolactone phase). Subsequently, for only RH and CH groups, 25 mg/d spironolactone was added to preexisting treatments over 6 months. Afterwards, these parameters were reassessed (post-spironolactone phase). The RH and CH groups achieved reductions in blood pressure (P<.001), decreases in left ventricular hypertrophy (P<.001), improved diastolic function (Kappa index RH: 0.219 and Kappa index CH: 0.392) and increases in aldosterone concentrations (P<.05). The RH group attained improved endothelium-dependent (P<.001) and independent (P=.007) function. Optimized RH treatment with spironolactone reduces blood pressure and improves endothelial and diastolic function and left ventricular hypertrophy despite the presence of aldosterone excess or escape.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Fri, 04 Sep 2009, 10:28:29 EST