Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone

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• dc.contributor.author Galceran Herrera, Isabel
• dc.contributor.author Vázquez, Susana
• dc.contributor.author Crespo Barrio, Marta
• dc.contributor.author Pascual Santos, Julio
• dc.contributor.author Oliveras, Anna
• dc.date.accessioned 2023-04-19T11:41:43Z
• dc.date.available 2023-04-19T11:41:43Z
• dc.date.issued 2023
• dc.description.abstract Introduction: Resistant hypertension (RH) represents an important multi-organic impact and increases the morbi-mortality. We aimed to evaluate the evolution of hypertensive mediated organ damage in patients with RH after adding spironolactone. Material and methods: Retrospective study of 58 patients with RH who started spironolactone (12.5-25mg daily). Office blood pressure, 24-h ambulatory blood pressure monitoring (24h-ABPM), urine albumin-to-creatinine ratio and echocardiographic parameters were analyzed prior to initiation of spironolactone and after 12 months of treatment. Results: Thirty-six percent of patients were women and mean age was 67.3±10.1 years. We observed a decrease in urine albumin-to-creatinine ratio (median [RIQ25-75]) of 27.0 (7.5-255.4) to 11.3 (3.1-37.8)mg/g, p=0.009. This was more relevant in patients with albuminuria grade A2 and A3: 371.2 (139.5-797.4) to 68.4 (26.5-186.5)mg/g, p=0.02. The echocardiographic changes were: posterior wall thickness: -1.0±0.4mm (p<0.001), interventricular septal thickness: -0.6±0.5mm (p=0.01), left ventricular (LV) mass index: -14.7±10.2g/m2 (p=0.006), LV remodeling index: -0.04±0.036 (p=0.03), without statistically significant changes in LV ejection fraction, LV end-diastolic diameter, LV end-systolic diameter, left atrial diameter, relationship between early ventricular filling wave and atrial contraction and LV filling pressure index. Systolic/diastolic office blood pressure decreased -12.5±4.9/-4.9±3.0mmHg, p<0.001. In 24h-ABPM, systolic and diastolic BP had a significant decrease in diurnal and nocturnal periods and 38.1% of patients presented a favorable change in the circadian pattern, p<0.001. Conclusions: Adding spironolactone to patients with RH contributes to improve hypertensive mediated organ damage by reducing albuminuria levels and echocardiographic parameters of hypertensive heart disease.
• dc.format.mimetype application/pdf
• dc.identifier.citation Galceran I, Vázquez S, Crespo M, Pascual J, Oliveras A. Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone. Nefrologia (Engl Ed). 2023 May-Jun;43(3):309-15. DOI: 10.1016/j.nefroe.2022.12.002
• dc.identifier.doi http://dx.doi.org/10.1016/j.nefroe.2022.12.002
• dc.identifier.issn 2013-2514
• dc.identifier.uri http://hdl.handle.net/10230/56504
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Nefrologia (Engl Ed). 2023 May-Jun;43(3):309-15
• dc.rights © 2022 Published by Elsevier España, S.L.U. on behalf of Sociedad Española de Nefrología. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword 24-h ambulatory blood pressure monitoring
• dc.subject.keyword Albuminuria
• dc.subject.keyword Echocardiography
• dc.subject.keyword Ecocardiograma
• dc.subject.keyword Espironolactona
• dc.subject.keyword Hipertensión arterial resistente
• dc.subject.keyword Presión arterial ambulatoria de 24h
• dc.subject.keyword Resistant hypertension
• dc.subject.keyword Spironolactone
• dc.title Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion