Hypertension and fear of falling: results from SPRINT
| Autor: | Alan J. Lerner, James R. Powell, Lewis E. Kazis, Tonya Breaux-Shropshire, Julie Williams, Dan R. Berlowitz, Capri G. Foy, Jill C. Newman, Lisa H. Gren, Virginia G. Wadley |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Aldosterone medicine.drug_class business.industry Metabolic alkalosis Calcium channel blocker medicine.disease Hypokalemia Amiloride Eplerenone chemistry.chemical_compound Blood pressure chemistry Internal medicine Internal Medicine medicine Spironolactone Physical therapy Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of the American Society of Hypertension. 9:e63 |
| ISSN: | 1933-1711 |
| Popis: | Hypertension presenting with metabolic alkalosis with hypokalemia is not uncommon. In this analysis, we present the management of such a scenario in white and black patients. Six patients (white1⁄44 [1 females, 2 males, age1⁄424-62]; blacks1⁄42 [1male, 1 female, age1⁄432, 40]) with hypokalemia (2.9-3.3 mEq/L), metabolic alkalosis (28-32 mm Eq/L) and hypertension (155-180/90-105 mmHg) were seen in hypertension clinic. All had a BMI of >32 and metabolic syndrome. None had clinical evidence of sleep apnea. All had been on adequate dosage of at least three BP meds (calcium channel blocker, ACE-I/ARB, metoprolol/carvedilol). All had a negative Doppler ultrasound for renal artery stenosis. Their serum aldosterone to renin ratio was 15-18 (normal1⁄4less than 20). Urinary aldosterone in the six patients ranged from 10-12 ng/l (reference abnormal1⁄4>14 ng/dl). Because of normal aldosterone to renin ration, CT scan was not obtained in these patients. Nonetheless, considering obesity and aldosterone production by adipocytes (high normal urinary aldosterone), treatment with spironolactone/eplerenone was initiated with normalization of blood pressure in 3/4 whites ( |
| Databáze: | OpenAIRE |
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