keyword
MENU ▼
Read by QxMD icon Read
search

Spironolactone resistant hypertension

keyword
https://www.readbyqxmd.com/read/29237722/pannexin-1-channels-as-an-unexpected-new-target-of-the-anti-hypertensive-drug-spironolactone
#1
Miranda E Good, Yu-Hsin Chiu, Ivan K Poon, Christopher B Medina, Joshua T Butcher, Suresh K Mendu, Leon J DeLalio, Alexander W Lohman, Norbert Leitinger, Eugene J Barrett, Ulrike M Lorenz, Bimal N Desai, Iris Z Jaffe, Douglas Bayliss, Brant E Isakson, Kodi S Ravichandran
Rationale: Resistant hypertension is a major health concern with unknown etiology. Spironolactone is an effective anti-hypertensive drug, especially for patients with resistant hypertension, and is considered by the World Health Organization (WHO) as an "essential" medication. Although spironolactone can act at the mineralocorticoid receptor (NR3C2), there is increasing evidence of mineralocorticoid receptor (MR)-independent effects of spironolactone. Objective: Here, we detail the unexpected discovery that pannexin 1 (Panx1) channels could be a relevant in vivo target of spironolactone...
December 13, 2017: Circulation Research
https://www.readbyqxmd.com/read/29228101/spironolactone-and-resistant-hypertension-in-heart-failure-with-preserved-ejection-fraction
#2
P Rossignol, B Claggett, J Liu, O Vardeny, B Pitt, F Zannad, S Solomon
Background: Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown. Methods: We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mmHg on 3 or more medications, in the Americas cohort of the TOPCAT trial, in which patients with HFpEF were randomized to spironolactone vs...
December 7, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29081661/managing-resistant-hypertension-focus-on-mineralocorticoid-receptor-antagonists
#3
REVIEW
Juan Carlos Yugar-Toledo, Rodrigo Modolo, Ana Paula de Faria, Heitor Moreno
Mineralocorticoid-receptor antagonists (MRAs) have proven to be effective in some types of hypertension, especially in resistant hypertension (RHTN). In this phenotype of hypertension, the renin-angiotensin-aldosterone pathway plays an important role, with MRAs being especially effective in reducing blood pressure. In this review, we show the relevance of aldosterone in RHTN, as well as some clinical characteristics of this condition and the main concepts involving its pathophysiology and cardiovascular damage...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#4
REVIEW
John W Funder
Spironolactone has been marketed for over half a century as a 'potassium-sparing diuretic', used primarily in patients with ascites. With the realization that primary aldosteronism is the most common (5-13%) form of secondary hypertension, it has become widely used as a mineralocorticoid receptor antagonist. More recently, in the wake of the RALES trial, spironolactone in addition to standard therapy has been shown to be very beneficial in heart failure with a reduced ejection fraction. Despite the failure of the TOPCAT trial, spironolactone is being increasingly used in diastolic heart failure (i...
2017: F1000Research
https://www.readbyqxmd.com/read/28905546/-hypertension-in-people-of-african-descent
#5
Fabien Cane, Sofia Zisimopoulou, Antoinette Pechère-Bertschi
Hypertension in people of African descent presents an increased prevalence, an earlier and more severe target organ damage and is harder to control compared to other ethnicities. Preeclampsia and gestational hypertension are more frequent in black women. The physiological phenomenon of night time blood pressure dipping is often blunted. The low renin hypertension phenotype seems to be caused by an increase in sodium retention at renal level. The treatment of choice is calcium channel blockers and thiazide diuretics along with a renin-angiotensin-aldosterone blocker for kidney protection...
September 13, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28880055/resistant-hypertension-an-overview
#6
Roberto Pedrinelli, Giulia Dell' Omo, Giuseppe Ambrosio, Matteo Cameli, Elisabetta Cerbai, Stefano Coiro, Michele Emdin, Riccardo Liga, Rossella Marcucci, Doralisa Morrone, Alberto Palazzuoli, Luigi Padeletti, Ketty Savino
Despite the availability of anti-hypertensive medications with proven efficacy and good tolerability, many hypertensive patients have blood pressure levels(BP) not at the goals set by international societies. Some of these patients are either non-adherent to the prescribed drugs or not optimally treated. However, a proportion, despite adequate treatment, has resistant hypertension(RH) defined as office BP above goal despite the use of ≥3 antihypertensive medications at maximally tolerated doses (one ideally being a diuretic)...
September 5, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28874460/citric-acid-metabolism-in-resistant-hypertension-underlying-mechanisms-and-metabolic-prediction-of-treatment-response
#7
Marta Martin-Lorenzo, Paula J Martinez, Montserrat Baldan-Martin, Gema Ruiz-Hurtado, Jose Carlos Prado, Julian Segura, Fernando de la Cuesta, Maria G Barderas, Fernando Vivanco, Luis Miguel Ruilope, Gloria Alvarez-Llamas
Resistant hypertension (RH) affects 9% to 12% of hypertensive adults. Prolonged exposure to suboptimal blood pressure control results in end-organ damage and cardiovascular risk. Spironolactone is the most effective drug for treatment, but not all patients respond and side effects are not negligible. Little is known on the mechanisms responsible for RH. We aimed to identify metabolic alterations in urine. In addition, a potential capacity of metabolites to predict response to spironolactone was investigated...
November 2017: Hypertension
https://www.readbyqxmd.com/read/28666228/high-throughput-quantification-of-8-antihypertensive-drugs-and-active-metabolites-in-human-plasma-using-uplc-ms-ms
#8
Bart C H van der Nagel, Jorie Versmissen, Soma Bahmany, Teun van Gelder, Birgit C P Koch
BACKGROUND: To assess drug adherence of patients with hypertension, an analytical method was developed and validated using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The method includes eight frequently prescribed antihypertensive drugs from four classes and their active metabolites: angiotensin converting enzyme inhibitors enalapril and perindopril (active metabolites respectively enalaprilate and perindoprilate), angiotensin II receptor blockers losartan (with the active metabolite losartan carboxylic acid) and valsartan, calcium channel blockers amlodipine and nifedipine and diuretics hydrochlorothiazide and spironolactone (with the active metabolite canrenone)...
August 15, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28448185/addition-of-spironolactone-in-patients-with-resistant-hypertension-a-meta-analysis-of-randomized-controlled-trials
#9
Liping Liu, Bing Xu, Yunfeng Ju
This study was designed to assess the effect of additional spironolactone on blood pressure in patients with resistant hypertension. MEDLINE, EMBASE, and Cochrane Library were searched to identify randomized controlled trials (RCTs) that determined the effect of add-on spironolactone on blood pressure in patients with resistant hypertension compared with a control group. A total of five RCTs met the inclusion criteria. Spironolactone reduced office systolic blood pressure (SBP) by 15.73 mmHg (95% CI -20.45 to -11...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28443356/sham-or-no-sham-control-that-is-the-question-in-trials-of-renal-denervation-for-resistant-hypertension-a-systematic-meta-analysis
#10
Fadl Elmula M Fadl Elmula, Ying-Mei Feng, Lotte Jacobs, Anne C Larstorp, Sverre E Kjeldsen, Alexandre Persu, Jan A Staessen
BACKGROUND: Studies of renal denervation (RDN) in patients with apparent treatment resistant hypertension have been hampered by a number of patient and physician related confounders on blood pressure (BP) including poor drug adherence. It remains uncertain whether RDN lowers BP. We aimed to investigate whether the use of sham control is essential in RDN studies or whether systematic use of 24-hour ambulatory BP provides enough information thereby making an invasive sham control redundant...
August 2017: Blood Pressure
https://www.readbyqxmd.com/read/28349274/a-systematic-review-of-add-on-pharmacologic-therapy-in-the-treatment-of-resistant-hypertension
#11
REVIEW
Anita P Tataru, Arden R Barry
INTRODUCTION: The objective of this systematic review was to evaluate the efficacy and safety of add-on pharmacologic therapies in the treatment of resistant hypertension (RH), defined as blood pressure (BP) above target despite three antihypertensive agents. METHODS: A systematic search was performed in MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and Google Scholar (inception to June 2016) to identify randomized controlled trials (RCTs) that compared any antihypertensive agent with control in patients with RH...
August 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28327653/association-of-aldosterone-excess-and-apnea-hypopnea-index-in-patients-with-resistant-hypertension
#12
Xiao Ke, Wenyu Guo, Hu Peng, Chengheng Hu, Henghong Zhang, Changnong Peng, Xiaoqing Wang
The present study was to investigate the association of aldosterone excess and apnea-hypopnea index (AHI) in patients with resistant hypertension. Patients with resistant hypertension were enrolled and baseline characteristics including plasma aldosterone concentration (PAC) and 24 h-urine aldosterone levels were collected and compared between groups with different degrees of AHI as assessed by polysomnography. Association of key variables and AHI was then evaluated by univariate and multiple linear regression analysis...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28275946/a-network-meta-analysis-of-clinical-management-strategies-for-treatment-resistant-hypertension-making-optimal-use-of-the-evidence
#13
Peter Makai, Joanna IntHout, Jaap Deinum, Kevin Jenniskens, Gert Jan van der Wilt
BACKGROUND: With the addition of surgical interventions to current medicinal treatments, it is increasingly challenging for clinicians to rationally choose among the various options for treating patients with apparent treatment-resistant hypertension (ATRHTN). This study aims to establish the comparative effectiveness of mineralocorticoid receptor antagonists (MRA), renal denervation (RDN), darusentan and central arteriovenous anastomosis (CAA) for patients with ATRHTN by performing a network meta-analysis...
August 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28236585/the-importance-of-genetic-counseling-and-genetic-screening-a-case-report-of-a-16-year-old-boy-with-resistant-hypertension-and-severe-hypokalemia
#14
Ze-Min Kuang, Ying Wang, Jia-Jie Wang, Jing-Hua Liu, Rong Zeng, Qi Zhou, Zhen-Qiu Yu, Long Jiang
Liddle's syndrome, an autosomal dominant form of monogenic hypertension, is characterized by salt-sensitive hypertension with early penetrance, hypokalemia, metabolic alkalosis, suppression of plasma rennin activity and aldosterone secretion, and a clear-cut response to epithelial sodium channel blockers but not spironolactone therapy. Here, we describe the case of a 16-year-old boy patient with resistant hypertension (maintain 170-180/100-110 mm Hg after administration four kinds of antiypertensive drugs) and severe hypokalemia...
March 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28129246/effects-of-continuous-positive-airway-pressure-treatment-on-aldosterone-excretion-in-patients-with-obstructive-sleep-apnoea-and-resistant-hypertension-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Fabio de Souza, Elizabeth S Muxfeldt, Victor Margallo, Arthur F Cortez, Aline H Cavalcanti, Gil F Salles
OBJECTIVE: Aldosterone excess has been equally associated with resistant hypertension (RHT) and obstructive sleep apnoea (OSA). We conducted a randomized controlled study to assess the effect of continuous positive airway pressure (CPAP) treatment on 24-h urinary aldosterone excretion in patients with RHT and moderate/severe OSA. METHODS: A total of 117 patients were randomized (57 CPAP and 60 control groups). Aldosterone excretion was determined by 24 h urine (24h-UAldo) collected at randomization and after 6 months of follow-up...
April 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28123500/effects-of-low-dose-tolvaptan-on-electrolyte-abnormality-and-hemodynamic-parameters-in-a-liver-cirrhosis-associated-portopulmonary-hypertension-patient-a-case-report
#16
Yoshito Ogihara, Norikazu Yamada, Kaoru Dohi, Akimasa Matsuda, Satoshi Ota, Ken Ishikura, Mashio Nakamura, Masaaki Ito
The present study reported a case of portopulmonary hypertension (POPH) that was secondary to underlying liver cirrhosis in a 58-year-old woman, who was successfully treated with low-dose tolvaptan. The patient had suffered from refractory peripheral edema and electrolyte abnormalities, including severe hypokalemia, under the combination therapy of sildenafil, ambrisentan, furosemide and spironolactone. Subsequent to the initiation of low-dose tolvaptan at 3.75 mg/day with concurrent de-escalation of the dose of furosemide, the daily urine volume increased, peripheral edema improved and the serum potassium level increased immediately...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28118281/renal-denervation-in-comparison-with-intensified-pharmacotherapy-in-true-resistant-hypertension-2-year-outcomes-of-randomized-prague-15-study
#17
RANDOMIZED CONTROLLED TRIAL
Ján Rosa, Petr Widimský, Petr Waldauf, Tomáš Zelinka, Ondřej Petrák, Miloš Táborský, Marian Branny, Petr Toušek, Karol Čurila, Lukáš Lambert, František Bednář, Robert Holaj, Branislav Štrauch, Jan Václavík, Eva Kociánová, Igor Nykl, Otakar Jiravský, Gabriela Rappová, Tomáš Indra, Zuzana Krátká, Jiří Widimský
OBJECTIVES: The randomized, multicentre study compared the efficacy of renal denervation (RDN) versus spironolactone addition in patients with true resistant hypertension. We present the 24-month data. METHODS: A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline SBP of 159 ± 17 and 155 ± 17 mmHg and average number of drugs 5...
May 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28091867/arterial-aortic-stiffness-in-patients-with-resistant-hypertension-from-assessment-to-treatment
#18
REVIEW
James E Sharman, Pierre Boutouyrie, Stéphane Laurent
PURPOSE OF REVIEW: The purpose of the review is to examine whether measurement of aortic stiffness could be especially value-adding for risk stratification and treatment among patients with resistant hypertension (RH). RECENT FINDINGS: Adverse arterial remodeling and increased aortic stiffness is associated with RH, and it may be of additional clinical benefit to measure aortic stiffness in these patients. However, there is insufficient evidence to determine whether aortic stiffness is excessively high relative to the level of blood pressure (BP) among people with RH...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28089457/a-meta-analysis-of-add-on-use-of-spironolactone-in-patients-with-resistant-hypertension
#19
Di Zhao, Hui Liu, Pingshuan Dong, Jingdong Zhao
OBJECTIVE: The efficacy of add-on use of spironolactone in patients with resistant hypertension has been investigated in several small studies. We performed this meta-analysis evaluating the efficacy of add-on use of spironolactone in these patients. METHODS: We searched Pubmed, Web of Science, and Cochrane Central for all published studies evaluating add-on use of spironolactone in patients with resistant hypertension. Only randomized controlled trials determining antihypertensive effects of spironolactone were considered...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28064163/predicting-albuminuria-response-to-spironolactone-treatment-with-urinary-proteomics-in-patients-with-type-2-diabetes-and-hypertension
#20
Morten Lindhardt, Frederik Persson, Christina Oxlund, Ib A Jacobsen, Petra Zürbig, Harald Mischak, Peter Rossing, Hiddo J L Heerspink
BACKGROUND: The mineralocorticoid receptor antagonist spironolactone significantly reduces albuminuria in patients with diabetes. Prior studies have shown large between-patient variability in albuminuria treatment response. We previously developed and validated a urinary proteomic classifier that predicts onset and progression of chronic kidney disease. Here, we tested whether the proteomic classifier based on 273 urinary peptides (CKD273) predicts albuminuria response to spironolactone treatment...
January 7, 2017: Nephrology, Dialysis, Transplantation
keyword
keyword
103544
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"