Regression of left ventricular hypertrophy in patients with primary aldosteronism/low-renin hypertension on low-dose spironolactone
| Autor: | Avry Chagnac, Asher Korzets, Uzi Gafter, Yaacov Ori, Michael Bergman, Michal Herman-Edelstein, Hertzel Salman, Boris Zingerman |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Spironolactone Essential hypertension Left ventricular hypertrophy chemistry.chemical_compound Primary aldosteronism Risk Factors Internal medicine Hyperaldosteronism Renin Renin–angiotensin system medicine Humans cardiovascular diseases Aged Mineralocorticoid Receptor Antagonists Retrospective Studies Transplantation Aldosterone E/A ratio business.industry Blood Pressure Determination Middle Aged Prognosis medicine.disease Survival Rate Blood pressure chemistry Echocardiography Nephrology Hypertension Cardiology Female Hypertrophy Left Ventricular Essential Hypertension business Follow-Up Studies |
| Zdroj: | Nephrology Dialysis Transplantation. 28:1787-1793 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfs587 |
| Popis: | BACKGROUND The incidence of left ventricular hypertrophy (LVH) in primary aldosteronism (PA) is higher than in essential hypertension. LVH is an independent cardiovascular risk factor. Treatment of PA with mineralocorticoid receptor blockers (MRBs) improves LVH. Previous studies included relatively small groups, low incidence of LVH and used high MRB dose. We tested the hypothesis that long-term regression of LVH in PA/low-renin hypertension may be achieved with low-dose MRB. METHODS Forty-eight patients (male/female 28/20, age 61.4 years, range 47-84) had PA (low renin, high aldosterone and high aldosterone/renin ratio, n=24) or low-renin hypertension (low renin, normal aldosterone and high aldosterone/renin ratio, n=24). All had either LVH or concentric remodelling. All had an echocardiogram both at baseline and at 1 year after the initiation of spironolactone. A subgroup of 29 patients had an echocardiogram at baseline, 1 year (range 0.5-1.5) and 3 years (range 1.8-7). RESULTS At baseline, spironolactone was commenced in all patients. The dose was 33.3±13.7 and 29.0±11.7 mg/day at 1 year and 3 years, respectively. A total of 73% of the patients received ≤37.5 mg/day. Introduction of spironolactone enabled the reduction of other antihypertensive medications (from 2.6±1.2 to 1.5±1.0 at 1 year). At 1 year, systolic and diastolic blood pressure decreased (149.3±14.1 to 126.2±12.0 mmHg, P |
| Databáze: | OpenAIRE |
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