Spironolactone reduces blood pressure and albuminuria of obese hypertensive patients with Metabolic Syndrome
| Autor: | Sergio Franca de Souza Fillho, Monica Barros Costa, Danielle Guedes Andrade Ezequiel, Thaís Chehuen Bicalho, Sarah de Paula Iennaco de Rezende, Rogério Baumgratz de Paula, Júlio César Moraes Lovisi |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Ambulatory blood pressure Adolescent Renal function Blood Pressure Spironolactone Young Adult chemistry.chemical_compound Mineralocorticoid receptor Internal medicine medicine Albuminuria Humans Obesity Prospective Studies Mineralocorticoid Receptor Antagonists Metabolic Syndrome Aldosterone business.industry General Medicine Middle Aged medicine.disease Blood pressure Endocrinology chemistry Hypertension Female medicine.symptom Metabolic syndrome business |
| Zdroj: | Jornal Brasileiro de Nefrologia. 35:69-72 |
| ISSN: | 0101-2800 |
| DOI: | 10.5935/01012800.20130011 |
| Popis: | INTRODUCTION: In recent years, a role for aldosterone in pathophysiology of metabolic syndrome and hypertension in this syndrome has been suggested. However, the treatment with antagonists of mineralocorticoid receptor in these individuals has not properly addressed. OBJECTIVE: To evaluate the effects of mineralocorticoid receptor blockade on blood pressure, inflammatory, metabolic and renal parameters in non-diabetic hypertensive individuals with the metabolic syndrome. METHODS: Twenty nine patients with metabolic syndrome were enrolled in a prospective protocol that consisted of 2 periods: baseline (2 weeks) in which demographic data were obtained and antihypertensive medicines were withdrawn, and treatment period when the individuals were treated with spironolactone 25-50 mg once-a-day, for 16 weeks. In both periods, inflammatory, metabolic and renal parameters were assessed and the 24-hour ambulatory blood pressure monitorization was performed. RESULTS: After spironolactone treatment, 24 hour systolic and diastolic blood pressure decreased from 143.5 ± 15.17 mmHg to 133.2 ± 17.34 mmHg (p = 0.025) and from 85.2 ± 11.10 mmHg to 79.3 ± 11.78 mmHg (p = 0.026), respectively. HDL-cholesterol increased from 44.0 ± 8.67 mg/dl to 49.0 ± 6.75mg/dl (p = 0.000) and C-reactive protein decreased significantly from 6.3 ± 7.54 mg/l to 4.6 ± 6.3 mg/l (p = 0.009). Fasting plasma glucose, insulin, HOMA-IR and triglycerides did not change significantly after mineralocorticoid receptor blockade. Estimated glomerular filtration rate did not change whereas the logarithm of albuminuria decreased significantly from 2.5 ± 0.92 to 2.0 ± 0.9 (p = 0.028). CONCLUSION: In hypertensive subjects with MS the administration of spironolactone in monotherapy was effective for hypertension control, decreased uri nary albumin excretion and increased HDL-cholester ol plasma. |
| Databáze: | OpenAIRE |
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