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

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...

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Autores: Galceran Herrera, Isabel, Vázquez, Susana, Crespo Barrio, Marta, Pascual Santos, Julio, Oliveras, Anna
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/56504
Acceso en línea:http://hdl.handle.net/10230/56504
http://dx.doi.org/10.1016/j.nefroe.2022.12.002
Access Level:acceso abierto
Palabra clave:24-h ambulatory blood pressure monitoring
Albuminuria
Echocardiography
Ecocardiograma
Espironolactona
Hipertensión arterial resistente
Presión arterial ambulatoria de 24h
Resistant hypertension
Spironolactone
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spelling Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactoneGalceran Herrera, IsabelVázquez, SusanaCrespo Barrio, MartaPascual Santos, JulioOliveras, Anna24-h ambulatory blood pressure monitoringAlbuminuriaEchocardiographyEcocardiogramaEspironolactonaHipertensión arterial resistentePresión arterial ambulatoria de 24hResistant hypertensionSpironolactoneIntroduction: 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.Elsevier202320232023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/56504http://dx.doi.org/10.1016/j.nefroe.2022.12.002reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésNefrologia (Engl Ed). 2023 May-Jun;43(3):309-15© 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/).http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/565042026-06-12T07:21:37Z
dc.title.none.fl_str_mv Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
title Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
spellingShingle Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
Galceran Herrera, Isabel
24-h ambulatory blood pressure monitoring
Albuminuria
Echocardiography
Ecocardiograma
Espironolactona
Hipertensión arterial resistente
Presión arterial ambulatoria de 24h
Resistant hypertension
Spironolactone
title_short Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
title_full Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
title_fullStr Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
title_full_unstemmed Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
title_sort Hypertensive mediated organ damage evolution in resistant hypertension patients after adding spironolactone
dc.creator.none.fl_str_mv Galceran Herrera, Isabel
Vázquez, Susana
Crespo Barrio, Marta
Pascual Santos, Julio
Oliveras, Anna
author Galceran Herrera, Isabel
author_facet Galceran Herrera, Isabel
Vázquez, Susana
Crespo Barrio, Marta
Pascual Santos, Julio
Oliveras, Anna
author_role author
author2 Vázquez, Susana
Crespo Barrio, Marta
Pascual Santos, Julio
Oliveras, Anna
author2_role author
author
author
author
dc.subject.none.fl_str_mv 24-h ambulatory blood pressure monitoring
Albuminuria
Echocardiography
Ecocardiograma
Espironolactona
Hipertensión arterial resistente
Presión arterial ambulatoria de 24h
Resistant hypertension
Spironolactone
topic 24-h ambulatory blood pressure monitoring
Albuminuria
Echocardiography
Ecocardiograma
Espironolactona
Hipertensión arterial resistente
Presión arterial ambulatoria de 24h
Resistant hypertension
Spironolactone
description 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.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023
2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/56504
http://dx.doi.org/10.1016/j.nefroe.2022.12.002
url http://hdl.handle.net/10230/56504
http://dx.doi.org/10.1016/j.nefroe.2022.12.002
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Nefrologia (Engl Ed). 2023 May-Jun;43(3):309-15
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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