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Aldosterone antagonist

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https://www.readbyqxmd.com/read/29034087/spironolactone-in-cardiovascular-disease-an-expanding-universe
#1
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/29032132/prognostic-importance-of-temporal-changes-in-resting-heart-rate-in-heart-failure-and-preserved-ejection-fraction-from-the-topcat-study
#2
Ali Vazir, Brian Claggett, Bertram Pitt, Inder Anand, Nancy Sweitzer, James Fang, Jerome Fleg, Jean Rouleau, Sanjiv Shah, Marc A Pfeffer, Scott D Solomon
OBJECTIVES: The aim of this study was to examine the relationship between baseline heart rate (HR), change in HR from a preceding visit, and time-updated HR with subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF) in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial. BACKGROUND: Higher resting HR and increase in HR over time in patients with heart failure are associated with adverse outcomes...
October 4, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/29019079/pharmacotherapy-choice-is-associated-with-2-year-mortality-for-patients-with-heart-failure-and-reduced-ejection-fraction
#3
Nancy M Albert, Dana A Drzayich Antol, Richard W DeClue, Adrianne Waldman Casebeer, Yong Li, Stephen Stemkowski, Chun-Lan Chang
INTRODUCTION: Factors associated with mortality for patients with heart failure and reduced ejection fraction (HFrEF) are known; however, the association between initial pharmacotherapy (IPT) and mortality is unclear in real-world settings. METHODS: Using a retrospective design and claims database, 14,359 Medicare patients with HFrEF from August 2010 to July 2015 were identified. Index date was first HF claim. IPT was mono- or combo-angiotensin-converting enzyme inhibitor (ACEI), angiotensin II receptor blocker (ARB), beta-blocker (BB), hydralazine-nitrate (HN), and aldosterone antagonist (AA) within 1 year post-index...
October 10, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28970286/obesity-stimulated-aldosterone-release-is-not-related-to-a-s1p-dependent-mechanism
#4
Stephan Werth, Helge Müller-Fielitz, Walter Raasch
Aldosterone has been identified as an important factor in obesity-associated hypertension. Here, we investigated whether sphingosine-1-phophate (S1P), which has previously been linked to obesity, increases aldosterone release. S1P-induced aldosterone release was determined in NCI H295R cells in the presence of S1P receptor (S1PR) antagonists. In vivo release of S1P (100-300 µg/kg bw) was investigated in pithed, lean Sprague Dawley (SD) rats, diet-obese spontaneous hypertensive rats (SHR), as well as in lean or obese Zucker rats...
October 2, 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28966243/the-aldosterone-receptor-antagonist-eplerenone-inhibits-isoproterenol-induced-collagen-i-and-11%C3%AE-hsd1-expression-in-rat-cardiac-fibroblasts-and-the-left-ventricle
#5
Yasutomo Hori, Daisuke Touei, Ryuta Saitoh, Maki Yamagishi, Kazutaka Kanai, Fumio Hoshi, Naoyuki Itoh
β-Adrenergic receptor (β-AR)-induction of collagen-I synthesis is partially mediated by the cardiac mineralocorticoid receptor (MR) system. However, it remains unclear whether the selective MR antagonist, eplerenone, inhibits collagen-I synthesis induced by β-AR stimulation. We investigated the effects of eplerenone on the responses to a non-selective β-AR agonist, isoproterenol, which induced collagen-I synthesis in primary cardiac fibroblasts (CFs) and the left ventricle. mRNAs encoding the MR and 11β-hydroxysteroid dehydrogenase type I (11β-HSD1) were evident in the left ventricle and primary CFs...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28944989/the-combination-of-valsartan-and-sacubitril-in-the-treatment-of-hypertension-and-heart-failure-an-update
#6
REVIEW
Peter Munch Nielsen, Daniela Grimm, Markus Wehland, Ulf Simonsen, Marcus Krüger
A novel antihypertensive drug, LCZ696 (Entresto®), has recently been introduced, which combines the action of an antagonist of the renin-angiotensin-aldosterone system (RAAS), effectively decreasing the blood pressure, with an inhibition of neprilysin, which is responsible for metabolizing natriuretic peptides exerting antihypertensive and antifibrotic effects. In this MiniReview, we describe the pharmacokinetics and pharmacodynamics, efficacy and side effects of the combined angiotensin receptor antagonist and neprilysin inhibitor LCZ696...
September 25, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28943982/awareness-of-physicians-and-pharmacists-of-aldosterone-antagonists-in-heart-failure-and-myocardial-infarction-in-jordan
#7
Fadia Mayyas, Khalid Ibrahim, Karem H Alzoubi
OBJECTIVE: to evaluate physicians and clinical pharmacists' awareness and practices regarding use of aldosterone antagonists in heart failure (HF) and post-myocardial infarction (MI). METHODS: First, we reviewed the prescription of aldosterone antagonists among 408 patients presenting to the cardiology clinic at a major hospital in Jordan. Second, physicians and pharmacists working in cardiovascular departments completed a questionnaire related to use of aldosterone antagonists in HF and post-MI...
July 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28939904/up-regulation-of-claudin-2-expression-by-aldosterone-in-colonic-epithelial-cells-of-mice-fed-with-nacl-depleted-diets
#8
Chisa Furukawa, Noriko Ishizuka, Hisayoshi Hayashi, Naoko Fujii, Aya Manabe, Yoshiaki Tabuchi, Toshiyuki Matsunaga, Satoshi Endo, Akira Ikari
Dietary NaCl depletion increases Na(+) absorption and K(+) secretion in the colon, but the mechanisms are not fully understood. In mice fed with NaCl-depleted diets, the expression of claudin-2 and -7 increased compared to those in control mice. Aldosterone (ALD) concentration was also increased. We examined the regulatory mechanism of claudin expression by ALD using the murine colonic epithelial MCE301 cells. ALD dose-dependently increased claudin-2 expression without affecting the expression of claudin-4, -7, -8, and -15...
September 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28934188/effect-of-aldosterone-antagonists-on-obstructive-sleep-apnea-in-patients-with-resistant-hypertension-a-systematic-review-and-meta-analysis
#9
W-D Zhang, J-W Zhang, K-F Wu, X Chen, Y-P Wang, L-H Zhou, H-T Wang, S-M Chen
No abstract text is available yet for this article.
September 21, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28926607/the-novel-mineralocorticoid-receptor-antagonist-finerenone-attenuates-neointima-formation-after-vascular-injury
#10
Jochen Dutzmann, Robert-Jonathan Musmann, Marco Haertlé, Jan-Marcus Daniel, Kristina Sonnenschein, Andreas Schäfer, Peter Kolkhof, Johann Bauersachs, Daniel G Sedding
BACKGROUND: The novel nonsteroidal mineralocorticoid receptor (MR) antagonist finerenone holds promise to be safe and efficient in the treatment of patients with heart failure and/or chronic kidney disease. However, its effects on vascular function remain elusive. PURPOSE: The aim of this study was to determine the functional effect of selective MR antagonism by finerenone in vascular cells in vitro and the effect on vascular remodeling following acute vascular injury in vivo...
2017: PloS One
https://www.readbyqxmd.com/read/28915854/medical-therapy-following-hospitalization-for-heart-failure-with-reduced-ejection-fraction-and-association-with-discharge-to-long-term-care-a-cross-sectional-analysis-of-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-population
#11
Emily B Levitan, Melissa K Van Dyke, Ligong Chen, Raegan W Durant, Todd M Brown, J David Rhodes, Olusola Olubowale, Oluwole Muyiwa Adegbala, Meredith L Kilgore, Justin Blackburn, Karen C Albright, Monika M Safford
BACKGROUND: Less intensive treatment for heart failure with reduced ejection fraction (HFrEF) may be appropriate for patients in long-term care settings because of limited life expectancy, frailty, comorbidities, and emphasis on quality of life. METHODS: We compared treatment patterns between REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants discharged to long-term care versus home following HFrEF hospitalizations. We examined medical records and Medicare pharmacy claims for 147 HFrEF hospitalizations among 80 participants to obtain information about discharge disposition and medication prescriptions and fills...
September 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28915330/impact-of-adrenal-steroids-on-regulation-of-adipose-tissue
#12
Marco Infante, Andrea Armani, Caterina Mammi, Andrea Fabbri, Massimiliano Caprio
Corticosteroids are secreted by the adrenal glands and control the functions of adipose tissue via the activation of mineralocorticoid receptor (MR) and glucocorticoid receptor (GR). In turn, adipocytes release a large variety of adipokines into the bloodstream, regulating the function of several organs and tissues, including the adrenal glands, hereby controlling corticosteroid production. In adipose tissue, the activation of the MR by glucocorticoids (GC) and aldosterone affects important processes such as adipocyte differentiation, oxidative stress, autophagic flux, adipokine expression as well as local production of GC through upregulation of the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1)...
September 12, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28893861/adrenal-venous-sampling-for-primary-aldosteronism-laboratory-medicine-best-practice
#13
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
September 11, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28892958/correlation-of-serum-prolactin-level-to-child-pugh-scoring-system-in-cirrhosis-of-liver
#14
Chaitanya H Balakrishnan, H Rajeev
INTRODUCTION: With the growing incidence of liver cirrhosis among Asians, the use of a biomarker such as prolactin, indicates the severity of the disease, its complications and serves as a tool for early intervention. AIM: To compare the efficacy of serum prolactin to the Child Pugh scoring system in cirrhosis of the liver and establish that serum prolactin is an early marker for complications of cirrhosis of the liver. MATERIALS AND METHODS: This was a comparative study on 60 patients admitted to the Department of General Medicine, KIMS from June 2014 to November 2015...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28870047/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-gitelman-syndrome
#15
(no author information available yet)
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. The prevalence of GS is even higher in Asia than other countries. The majority of GS patients present mild and nonspecific symptoms during adolescence or adulthood...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28855315/eplerenone-prevented-obesity-induced-inflammasome-activation-and-glucose-intolerance
#16
Tsutomu Wada, Akari Ishikawa, Eri Watanabe, Yuto Nakamura, Yusuke Aruga, Hayate Hasegawa, Yasuhiro Onogi, Hiroe Honda, Yoshinori Nagai, Kiyoshi Takatsu, Yoko Ishii, Masakiyo Sasahara, Daisuke Koya, Hiroshi Tsuneki, Toshiyasu Sasaoka
Obesity-associated activation of the renin-angiotensin-aldosterone system is implicated in the pathogenesis of insulin resistance; however, influences of mineralocorticoid receptor (MR) inhibition remain unclear. Therefore, we aimed to clarify the anti-inflammatory mechanisms of MR inhibition using eplerenone, a selective MR antagonist, in C57BL/6 mice fed a high-fat diet (HFD) for 12 weeks. Eplerenone prevented excessive body weight gain and fat accumulation, ameliorated glucose intolerance and insulin resistance and enhanced energy metabolism...
December 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28845853/-resistant-hypertension-in-the-elderly
#17
Paolo Cicconetti, Alessandra Di Berardino, Maria Tortorelli D'Ambrosio, Mauro Cacciafesta
Actually, in literature there are no epidemiologic studies on the prevalence of resistant hypertension in the elderly; however the National Health and Nutrition Examination Survey observed in the adult population prevalence of 12.8% to clinical measurement. But, especially in elderly, it's necessary exclude pseudoresistance forms due to white coat hypertension, arterial stiffness, poor patient compliance to therapy, excessive salt intake, abuse of non-steroidal ant-inflammatory drugs and the forms of secondary hypertension...
July 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28831241/ambulatory-blood-pressure-parameters-after-canrenone-addition-to-existing-treatment-regimens-with-maximum-tolerated-dose-of-angiotensin-converting-enzyme-inhibitors-angiotensin-ii-type-1-receptor-blockers-plus-hydrochlorothiazide-in-uncontrolled-hypertensive
#18
Luigina Guasti, Giovanni Gaudio, Alessandro Lupi, Marinella D'Avino, Carla Sala, Amedeo Mugellini, Vito Vulpis, Salvatore Felis, Riccardo Sarzani, Massimo Vanasia, Pamela Maffioli, Giuseppe Derosa
BACKGROUND: Blockade of the renin-angiotensin-aldosterone system is a cornerstone in cardiovascular disease prevention and hypertension treatment. The relevance of ambulatory blood pressure monitoring (ABPM) has been widely confirmed for both increasing the accuracy of blood pressure (BP) measurements, particularly in pharmacological trials, and focusing on 24 h BP prognostic parameters. The aim of this study was to assess the effects of canrenone addition on ambulatory BP in uncontrolled hypertensive patients already treated with the highest tolerated dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor (AT1R) antagonists plus hydrochlorothiazide (HCT)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28814143/ly3045697-results-from-two-randomized-clinical-trials-of-a-novel-inhibitor-of-aldosterone-synthase
#19
Joanne Sloan-Lancaster, Eyas Raddad, Amy Flynt, Yan Jin, James Voelker, Jeffrey W Miller
INTRODUCTION: LY3045697 is a potent and selective aldosterone synthase (CYP11B2) inhibitor that was developed as a safer alternative to mineralocorticoid receptor antagonists. Effects of LY3045697 on aldosterone and cortisol synthesis, as well as potassium ion homeostasis, were evaluated in two clinical studies in healthy subjects. MATERIALS AND METHODS: Two incomplete, placebo-controlled crossover-design clinical studies examined safety, pharmacodynamics, and pharmacokinetics under single and repeated dose conditions in healthy subjects...
July 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/28801620/a-novel-aldosterone-antagonist-limits-renal-injury-in-5-6-nephrectomy
#20
Clarice K Fujihara, M C Kowala, M D Breyer, Claudia R Sena, Mariliza V Rodrigues, Simone C A Arias, Camilla Fanelli, Denise M Malheiros, P K Jadhav, Chahrzad Montrose-Rafizadeh, Jose E Krieger, Roberto Zatz
Aldosterone antagonists slow the progression of chronic kidney disease (CKD), but their use is limited by hyperkalemia, especially when associated with RAS inhibitors. We examined the renoprotective effects of Ly, a novel non-steroidal mineralocorticoid receptor (MR) blocker, through two experimental protocols: In Protocol 1, male Munich-Wistar rats underwent 5/6 renal ablation (Nx), being divided into: Nx+V, receiving vehicle, Nx+Eple, given eplerenone, 150 mg/kg/day, and Nx+Ly, given Ly, 20 mg/kg/day...
August 11, 2017: Scientific Reports
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