Aldosterone excess or escape: Treating resistant hypertension. Journal of clinical hypertension (Greenwich, Conn.) [J Clin Hypertens (Greenwich)] Journal article

Title	Aldosterone excess or escape: Treating resistant hypertension.
Author(s)	Ubaid-Girioli S, Adriana de Souza L, Yugar-Toledo JC, Martins LC, Ferreira-Melo S, Coelho OR, Sierra C, Coca A, Pimenta E, Moreno H
Institution	Department of Pharmacology, State University of Campinas, SP, Brazil.
Source	J Clin Hypertens (Greenwich) 2009 May; 11(5):245-52.
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.
Language	eng
Pub Type(s)	Journal Article Research Support, Non-U.S. Gov't
PubMed ID	19534021

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