Back to Search
Start Over
Spironolactone Reduces Aortic Stiffness in Patients With Resistant Hypertension Independent of Blood Pressure Change
- Source :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 17 (2021), Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Background Aortic stiffness is an independent predictor of cardiovascular events in patients with arterial hypertension. Resistant hypertension is often linked to hyperaldosteronism and associated with adverse outcomes. Spironolactone, a mineralocorticoid receptor antagonist, has been shown to reduce both the arterial blood pressure (BP) and aortic stiffness in resistant hypertension. However, the mechanism of aortic stiffness reduction by spironolactone is not well understood. We hypothesized that spironolactone reduces aortic stiffness in resistant hypertension independently of BP change. Methods and Results Patients with uncontrolled BP (≥140/90 mm Hg) despite use of ≥3 antihypertensive medications (including diuretics) were prospectively recruited. Participants were started on spironolactone at 25 mg/d, and increased to 50 mg/d at 4 weeks while other antihypertensive medications were withdrawn to maintain constant mean BP. Phase‐contrast cardiac magnetic resonance imaging of the ascending aorta was performed in 30 participants at baseline and after 6 months of spironolactone treatment to measure aortic pulsatility, distensibility, and pulse wave velocity. Pulse wave velocity decreased (6.3±2.3 m/s to 4.5±1.8 m/s, P P P Conclusions Our results suggest that spironolactone improves aortic properties in resistant hypertension independently of BP, which may support the hypothesis of an effect of aldosterone on the arterial wall. A larger prospective study is needed to confirm our findings.
- Subjects :
- medicine.medical_specialty
Blood pressure change
Resistant hypertension
Blood Pressure
Pulse Wave Analysis
Independent predictor
chemistry.chemical_compound
Vascular Stiffness
Internal medicine
medicine.artery
Clinical Studies
medicine
Humans
Diseases of the circulatory (Cardiovascular) system
In patient
Antihypertensive Agents
Original Research
Aorta
business.industry
resistant hypertension
medicine.disease
Hyperaldosteronism
aorta
spironolactone
chemistry
RC666-701
Hypertension
Spironolactone
Cardiology
Aortic stiffness
hyperaldosteronism
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 20479980
- Volume :
- 10
- Issue :
- 17
- Database :
- OpenAIRE
- Journal :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
- Accession number :
- edsair.doi.dedup.....79e704512be20382688e66fcac579e6a