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Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension.
Hypertens Res 1999; 22(1):17-22HR

Abstract

There is increasing evidence for important cardiovascular effects of aldosterone via classical mineralocorticoid receptors in the heart. Administration of aldosterone with excess salt produces both cardiac hypertrophy and interstitial cardiac fibrosis in rats, and concomitant administration of potassium canrenoate at a dose that only modestly lowers blood pressure completely blocks the cardiac effects of aldosterone. In the present study, we examined the effect on left ventricular hypertrophy of adding a low dose of the mineralocorticoid receptor antagonist spironolactone (25 mg/d) to an angiotensin-converting enzyme inhibitor (enalapril maleate) in patients with essential hypertension. Eighteen untreated patients with moderate to severe essential hypertension based on the WHO/ISH guidelines participated in this study. Subjects were treated with either an angiotensin-converting enzyme inhibitor alone (group I: 10 patients, 4 men and 6 women, mean age 56 +/- 18 yr) or an angiotensin-converting enzyme inhibitor plus spironolactone (group II: 8 patients, 3 men and 5 women, mean age 59 +/- 14 yr) for 9 mo. Left ventricular mass index, various echocardiographic variables, mean blood pressure, plasma renin activity, and plasma aldosterone concentration before treatment were similar in the two groups. Blood pressure of both groups decreased significantly and similarly after antihypertensive treatment (group I, 136 +/- 9/82 +/- 9 mmHg; group II, 133 +/- 9/85 +/- 10 mmHg). Left ventricular mass index also decreased significantly in both groups (group I, -10.2 +/- 7.1%; group II, -18.1 +/- 6.9%). The extent of reduction was significantly greater in the spironolactone group (group II) (p < 0.05 vs. group I). In group II patients, spironolactone did not cause any side effects during the observation period. We conclude that spironolactone may have beneficial effects on left ventricular hypertrophy in patients with essential hypertension who are receiving an angiotensin-converting enzyme inhibitor.

Authors+Show Affiliations

Department of Internal Medicine, Mito Red Cross Hospital, Ibaraki, Japan.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

10221346

Citation

Sato, A, et al. "Effects of Spironolactone and Angiotensin-converting Enzyme Inhibitor On Left Ventricular Hypertrophy in Patients With Essential Hypertension." Hypertension Research : Official Journal of the Japanese Society of Hypertension, vol. 22, no. 1, 1999, pp. 17-22.
Sato A, Suzuki Y, Saruta T. Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. Hypertens Res. 1999;22(1):17-22.
Sato, A., Suzuki, Y., & Saruta, T. (1999). Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 22(1), pp. 17-22.
Sato A, Suzuki Y, Saruta T. Effects of Spironolactone and Angiotensin-converting Enzyme Inhibitor On Left Ventricular Hypertrophy in Patients With Essential Hypertension. Hypertens Res. 1999;22(1):17-22. PubMed PMID: 10221346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. AU - Sato,A, AU - Suzuki,Y, AU - Saruta,T, PY - 1999/4/30/pubmed PY - 1999/4/30/medline PY - 1999/4/30/entrez SP - 17 EP - 22 JF - Hypertension research : official journal of the Japanese Society of Hypertension JO - Hypertens. Res. VL - 22 IS - 1 N2 - There is increasing evidence for important cardiovascular effects of aldosterone via classical mineralocorticoid receptors in the heart. Administration of aldosterone with excess salt produces both cardiac hypertrophy and interstitial cardiac fibrosis in rats, and concomitant administration of potassium canrenoate at a dose that only modestly lowers blood pressure completely blocks the cardiac effects of aldosterone. In the present study, we examined the effect on left ventricular hypertrophy of adding a low dose of the mineralocorticoid receptor antagonist spironolactone (25 mg/d) to an angiotensin-converting enzyme inhibitor (enalapril maleate) in patients with essential hypertension. Eighteen untreated patients with moderate to severe essential hypertension based on the WHO/ISH guidelines participated in this study. Subjects were treated with either an angiotensin-converting enzyme inhibitor alone (group I: 10 patients, 4 men and 6 women, mean age 56 +/- 18 yr) or an angiotensin-converting enzyme inhibitor plus spironolactone (group II: 8 patients, 3 men and 5 women, mean age 59 +/- 14 yr) for 9 mo. Left ventricular mass index, various echocardiographic variables, mean blood pressure, plasma renin activity, and plasma aldosterone concentration before treatment were similar in the two groups. Blood pressure of both groups decreased significantly and similarly after antihypertensive treatment (group I, 136 +/- 9/82 +/- 9 mmHg; group II, 133 +/- 9/85 +/- 10 mmHg). Left ventricular mass index also decreased significantly in both groups (group I, -10.2 +/- 7.1%; group II, -18.1 +/- 6.9%). The extent of reduction was significantly greater in the spironolactone group (group II) (p < 0.05 vs. group I). In group II patients, spironolactone did not cause any side effects during the observation period. We conclude that spironolactone may have beneficial effects on left ventricular hypertrophy in patients with essential hypertension who are receiving an angiotensin-converting enzyme inhibitor. SN - 0916-9636 UR - https://www.unboundmedicine.com/medline/citation/10221346/Effects_of_spironolactone_and_angiotensin_converting_enzyme_inhibitor_on_left_ventricular_hypertrophy_in_patients_with_essential_hypertension_ L2 - http://joi.jlc.jst.go.jp/JST.Journalarchive/hypres1992/22.17?from=PubMed DB - PRIME DP - Unbound Medicine ER -