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Aldosterone excess or escape: Treating resistant hypertension
Samira Ubaid-Girioli1, Leoní Adriana de Souza, Juan Carlos Yugar-Toledo
1Department of Pharmacology, State University of Campinas, SP, Brazil.
Journal of Clinical Hypertension (Greenwich, Conn.)
|June 19, 2009
Summary
Spironolactone effectively treats resistant hypertension by lowering blood pressure and improving heart and blood vessel function. This medication helps manage aldosterone excess or escape, benefiting patients with resistant hypertension.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Aldosterone excess or
- escape
- can complicate treatment for conditions like resistant hypertension (RH). Spironolactone is a key medication for managing RH.
Purpose of the Study:
- To evaluate the effects of spironolactone on cardiovascular parameters in patients with resistant hypertension (RH) and controlled hypertension (CH).
- To assess changes in endothelial function, cardiac structure, and aldosterone levels following spironolactone treatment.
Main Methods:
- Baseline assessments included echocardiography, flow-mediated vasodilation, carotid intima-media thickness, and hormonal/electrolyte levels.
- Resistant (RH) and controlled hypertension (CH) groups received 25 mg/d spironolactone for 6 months.
- Post-treatment reassessment of all parameters was performed.
Main Results:
- Spironolactone significantly reduced blood pressure and left ventricular hypertrophy in both RH and CH groups.
- Diastolic function improved in both groups, with enhanced endothelial function observed in the RH group.
- Aldosterone concentrations increased post-treatment, indicating aldosterone escape or excess.
Conclusions:
- Optimized treatment with spironolactone lowers blood pressure in RH patients.
- Spironolactone improves endothelial and diastolic function and reduces left ventricular hypertrophy in RH.
- These benefits occur even with concurrent aldosterone excess or escape.
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