Role of aldosterone in the antihypertensive effect of spironolactone in essential hypertension
| Autor: | H. B. Benraad, Peter W. C. Kloppenborg, J. I. M. Drayer, Th. Benraad, Willibrord H. L. Hoefnagels |
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| Rok vydání: | 1978 |
| Předmět: |
Adult
Male Mean arterial pressure medicine.medical_specialty Renal function Blood Pressure Spironolactone Essential hypertension Kidney Plasma renin activity chemistry.chemical_compound Electrolytes Internal medicine Renin Medicine Humans Pharmacology (medical) Aldosterone Pharmacology business.industry Body Weight Middle Aged medicine.disease Hyperaldosteronism Blood pressure Endocrinology chemistry Hypertension Female business |
| Zdroj: | Clinical pharmacology and therapeutics. 24(6) |
| ISSN: | 0009-9236 |
| Popis: | In order to evaluate the relationship between aldosterone status and the blood pressure-lowering effect of spironolactone, 38 patients with essential hypertension were treated with spironolactone (400 mg/day) during one week in hospital on a rigidly sodium-restricted diet. The degree of hyperaldosteronism was assessed by the aldosterone secretory rate after 5 days of salt loading (315 mmol Na+/day). The mean arterial pressure decreased 5.6% (range, -21 to +8%). When the patients were divided into subgroups with low and normal renin activity, there was no difference in the change in mean arterial pressure (-5.0% and -6.1%). When the patients were divided into three groups with low, normal, and supranormal aldosterone secretory rates, the last group had a significantly greater fall in blood pressure after the spironolactone than the other groups (-1.0, -7.1, -11.1%). Thus there was a correlation between the aldosterone secretory rate after sodium loading and the blood pressure-lowering effect of spironolactone (r = -0.53, p less than 0.01). The blood pressure-lowering effect was not related to changes in body weight, kidney function, or plasma electrolytes. Our findings do not provide solid arguments for the view that the blood pressure-lowering effect of high dose spironolactone is due to its antimineralocorticoid activity, but the correlation between the degree of hyperaldosteronism and the blood pressure-lowering effect strongly suggests that aldosterone does play a role in the genesis or maintenance of the hypertension in these patients. |
| Databáze: | OpenAIRE |
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