Aldosterone Escape With Diuretic or Angiotensin‐Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Combination Therapy in Patients With Mild to Moderate Hypertension
Renin‐angiotensin‐aldosterone system (RAAS) hyperactivity is implicated in the development of hypertension and progressive damage in target organs. Chronic inhibition of the RAAS or use of thiazide‐type diuretics may trigger an aldosterone escape. The aim of this study was to assess this phenomenon...
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| Veröffentlicht in: | The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2007-10, Vol.9 (10), p.770-774 |
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| container_title | The journal of clinical hypertension (Greenwich, Conn.) |
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| creator | Ubaid‐Girioli, Samira Ferreira‐Melo, Sílvia Elaine Souza, Leoní Adriana Nogueira, Eduardo Arantes Yugar‐Toledo, Juan Carlos Coca, Antonio Moreno, Heitor |
| description | Renin‐angiotensin‐aldosterone system (RAAS) hyperactivity is implicated in the development of hypertension and progressive damage in target organs. Chronic inhibition of the RAAS or use of thiazide‐type diuretics may trigger an aldosterone escape. The aim of this study was to assess this phenomenon in hypertensive patients treated with thiazide‐type diuretics (hydrochlorothiazide [HCTZ]) or single or double blockade of the RAAS (irbesartan [IRBE], quinapril [QUIN], and IRBE+QUIN). Blood pressure levels were obtained by 24‐hour ambulatory blood pressure monitoring. Plasma renin activity and aldosterone levels were determined by immunoradiometric assay. Blood pressure level was normalized in the 4 treatment groups; the HCTZ and IRBE+QUIN groups showed an increased plasma aldosterone level after 12 weeks (9.1 ±2.2 to 14.1 ±1.4 and 6.9±1.9 to 12.9±2.3 ng/dL, respectively; P |
| doi_str_mv | 10.1111/j.1751-7176.2007.tb00091.x |
| format | Article |
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Chronic inhibition of the RAAS or use of thiazide‐type diuretics may trigger an aldosterone escape. The aim of this study was to assess this phenomenon in hypertensive patients treated with thiazide‐type diuretics (hydrochlorothiazide [HCTZ]) or single or double blockade of the RAAS (irbesartan [IRBE], quinapril [QUIN], and IRBE+QUIN). Blood pressure levels were obtained by 24‐hour ambulatory blood pressure monitoring. Plasma renin activity and aldosterone levels were determined by immunoradiometric assay. Blood pressure level was normalized in the 4 treatment groups; the HCTZ and IRBE+QUIN groups showed an increased plasma aldosterone level after 12 weeks (9.1 ±2.2 to 14.1 ±1.4 and 6.9±1.9 to 12.9±2.3 ng/dL, respectively; P<.05), whereas plasma renin activity was increased only in the HCTZ group (0.9 ±0.2‐1.7 ±0.2 ng/mL/h; P<.05). The increase in plasma aldosterone level after 12 weeks of HCTZ and IRBE+QUIN therapy suggests early aldosterone escape.</description><identifier>ISSN: 1524-6175</identifier><identifier>EISSN: 1751-7176</identifier><identifier>DOI: 10.1111/j.1751-7176.2007.tb00091.x</identifier><identifier>PMID: 17917504</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Ltd</publisher><subject>Aldosterone - blood ; Angiotensin II Type 1 Receptor Blockers - therapeutic use ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Biphenyl Compounds - therapeutic use ; Diuretics - therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Hydrochlorothiazide - therapeutic use ; Hypertension - blood ; Hypertension - drug therapy ; Irbesartan ; Male ; Middle Aged ; Original Paper ; Quinapril ; Tetrahydroisoquinolines - therapeutic use ; Tetrazoles - therapeutic use</subject><ispartof>The journal of clinical hypertension (Greenwich, Conn.), 2007-10, Vol.9 (10), p.770-774</ispartof><rights>2007 Le Jacq</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3931-9d8c1ca1eed599a2fecd6fa21eb2904a1e36bb7b897b0dfbfa4c38e93f7bcc953</citedby><cites>FETCH-LOGICAL-c3931-9d8c1ca1eed599a2fecd6fa21eb2904a1e36bb7b897b0dfbfa4c38e93f7bcc953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109961/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8109961/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,725,778,782,883,1414,1430,27907,27908,45557,45558,46392,46816,53774,53776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17917504$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ubaid‐Girioli, Samira</creatorcontrib><creatorcontrib>Ferreira‐Melo, Sílvia Elaine</creatorcontrib><creatorcontrib>Souza, Leoní Adriana</creatorcontrib><creatorcontrib>Nogueira, Eduardo Arantes</creatorcontrib><creatorcontrib>Yugar‐Toledo, Juan Carlos</creatorcontrib><creatorcontrib>Coca, Antonio</creatorcontrib><creatorcontrib>Moreno, Heitor</creatorcontrib><title>Aldosterone Escape With Diuretic or Angiotensin‐Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Combination Therapy in Patients With Mild to Moderate Hypertension</title><title>The journal of clinical hypertension (Greenwich, Conn.)</title><addtitle>J Clin Hypertens (Greenwich)</addtitle><description>Renin‐angiotensin‐aldosterone system (RAAS) hyperactivity is implicated in the development of hypertension and progressive damage in target organs. Chronic inhibition of the RAAS or use of thiazide‐type diuretics may trigger an aldosterone escape. The aim of this study was to assess this phenomenon in hypertensive patients treated with thiazide‐type diuretics (hydrochlorothiazide [HCTZ]) or single or double blockade of the RAAS (irbesartan [IRBE], quinapril [QUIN], and IRBE+QUIN). Blood pressure levels were obtained by 24‐hour ambulatory blood pressure monitoring. Plasma renin activity and aldosterone levels were determined by immunoradiometric assay. Blood pressure level was normalized in the 4 treatment groups; the HCTZ and IRBE+QUIN groups showed an increased plasma aldosterone level after 12 weeks (9.1 ±2.2 to 14.1 ±1.4 and 6.9±1.9 to 12.9±2.3 ng/dL, respectively; P<.05), whereas plasma renin activity was increased only in the HCTZ group (0.9 ±0.2‐1.7 ±0.2 ng/mL/h; P<.05). The increase in plasma aldosterone level after 12 weeks of HCTZ and IRBE+QUIN therapy suggests early aldosterone escape.</description><subject>Aldosterone - blood</subject><subject>Angiotensin II Type 1 Receptor Blockers - therapeutic use</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Biphenyl Compounds - therapeutic use</subject><subject>Diuretics - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Humans</subject><subject>Hydrochlorothiazide - therapeutic use</subject><subject>Hypertension - blood</subject><subject>Hypertension - drug therapy</subject><subject>Irbesartan</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Quinapril</subject><subject>Tetrahydroisoquinolines - therapeutic use</subject><subject>Tetrazoles - therapeutic use</subject><issn>1524-6175</issn><issn>1751-7176</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkdFu0zAUhiMEYmPwCsjigrtmdpwmMRJIJXS0aBMIDXFp2c5J65Lame2OZVc8Ao_CM_EkOGo1xiW-OdZ_vvOfI_1J8oLglMR3uklJOSWTkpRFmmFcpkFijBlJbx4kx3eth_E_zfJJEZWj5In3G4ynlDL8ODkiJYsqzo-TX7OusT6AswbQ3CvRA_qqwxq90zsHQStkHZqZlbYBjNfm94-ftTXX4II2KzQ3t8MW0NKstdTButN7JFou0WdQ0Ecdve2s-gYO1XYrtRFBW4Mu1-BEP6CIfooKmOD3qy9016Bg0YVtIhEALYY-LhxdrXmaPGpF5-HZoZ4kX87ml_Vicv7x_bKenU8UZZRMWFMpogQBaKaMiawF1RStyAjIjOE8NmghZSkrVkrctLIVuaIVMNqWUik2pSfJm71vv5NbaFQ8z4mO905vhRu4FZr_2zF6zVf2mlcEM1aQaPDyYODs1Q584FvtFXSdMGB3nhcVzStMcQRf7UHlrPcO2rslBPMxcL7hY6p8TJWPgfND4PwmDj-_f-bf0UPCEXi9B77rDob_sOYf6gUj9A_Aw8NC</recordid><startdate>200710</startdate><enddate>200710</enddate><creator>Ubaid‐Girioli, Samira</creator><creator>Ferreira‐Melo, Sílvia Elaine</creator><creator>Souza, Leoní Adriana</creator><creator>Nogueira, Eduardo Arantes</creator><creator>Yugar‐Toledo, Juan Carlos</creator><creator>Coca, Antonio</creator><creator>Moreno, Heitor</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200710</creationdate><title>Aldosterone Escape With Diuretic or Angiotensin‐Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Combination Therapy in Patients With Mild to Moderate Hypertension</title><author>Ubaid‐Girioli, Samira ; Ferreira‐Melo, Sílvia Elaine ; Souza, Leoní Adriana ; Nogueira, Eduardo Arantes ; Yugar‐Toledo, Juan Carlos ; Coca, Antonio ; Moreno, Heitor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3931-9d8c1ca1eed599a2fecd6fa21eb2904a1e36bb7b897b0dfbfa4c38e93f7bcc953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aldosterone - blood</topic><topic>Angiotensin II Type 1 Receptor Blockers - therapeutic use</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Biphenyl Compounds - therapeutic use</topic><topic>Diuretics - therapeutic use</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Humans</topic><topic>Hydrochlorothiazide - therapeutic use</topic><topic>Hypertension - blood</topic><topic>Hypertension - drug therapy</topic><topic>Irbesartan</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Quinapril</topic><topic>Tetrahydroisoquinolines - therapeutic use</topic><topic>Tetrazoles - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ubaid‐Girioli, Samira</creatorcontrib><creatorcontrib>Ferreira‐Melo, Sílvia Elaine</creatorcontrib><creatorcontrib>Souza, Leoní Adriana</creatorcontrib><creatorcontrib>Nogueira, Eduardo Arantes</creatorcontrib><creatorcontrib>Yugar‐Toledo, Juan Carlos</creatorcontrib><creatorcontrib>Coca, Antonio</creatorcontrib><creatorcontrib>Moreno, Heitor</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The journal of clinical hypertension (Greenwich, Conn.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ubaid‐Girioli, Samira</au><au>Ferreira‐Melo, Sílvia Elaine</au><au>Souza, Leoní Adriana</au><au>Nogueira, Eduardo Arantes</au><au>Yugar‐Toledo, Juan Carlos</au><au>Coca, Antonio</au><au>Moreno, Heitor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aldosterone Escape With Diuretic or Angiotensin‐Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Combination Therapy in Patients With Mild to Moderate Hypertension</atitle><jtitle>The journal of clinical hypertension (Greenwich, Conn.)</jtitle><addtitle>J Clin Hypertens (Greenwich)</addtitle><date>2007-10</date><risdate>2007</risdate><volume>9</volume><issue>10</issue><spage>770</spage><epage>774</epage><pages>770-774</pages><issn>1524-6175</issn><eissn>1751-7176</eissn><abstract>Renin‐angiotensin‐aldosterone system (RAAS) hyperactivity is implicated in the development of hypertension and progressive damage in target organs. Chronic inhibition of the RAAS or use of thiazide‐type diuretics may trigger an aldosterone escape. The aim of this study was to assess this phenomenon in hypertensive patients treated with thiazide‐type diuretics (hydrochlorothiazide [HCTZ]) or single or double blockade of the RAAS (irbesartan [IRBE], quinapril [QUIN], and IRBE+QUIN). Blood pressure levels were obtained by 24‐hour ambulatory blood pressure monitoring. Plasma renin activity and aldosterone levels were determined by immunoradiometric assay. Blood pressure level was normalized in the 4 treatment groups; the HCTZ and IRBE+QUIN groups showed an increased plasma aldosterone level after 12 weeks (9.1 ±2.2 to 14.1 ±1.4 and 6.9±1.9 to 12.9±2.3 ng/dL, respectively; P<.05), whereas plasma renin activity was increased only in the HCTZ group (0.9 ±0.2‐1.7 ±0.2 ng/mL/h; P<.05). 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| subjects | Aldosterone - blood Angiotensin II Type 1 Receptor Blockers - therapeutic use Angiotensin-Converting Enzyme Inhibitors - therapeutic use Biphenyl Compounds - therapeutic use Diuretics - therapeutic use Drug Therapy, Combination Female Humans Hydrochlorothiazide - therapeutic use Hypertension - blood Hypertension - drug therapy Irbesartan Male Middle Aged Original Paper Quinapril Tetrahydroisoquinolines - therapeutic use Tetrazoles - therapeutic use |
| title | Aldosterone Escape With Diuretic or Angiotensin‐Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Combination Therapy in Patients With Mild to Moderate Hypertension |
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