*Corresponding Author: Mario Bendersky, Professor of Pharmacology, Cordoba State University, Derqui, Carlos Paz, Córdoba, Argentina.
Citation: M Bendersky. (2021). Confirmatory results about Spironolactone (S) Effects on AASI in Essential Hypertensive Patients: Short communication. International Journal of Clinical Case Reports and Reviews. 8(3); DOI:10.31579/2690-4861/151
Copyright: © 2021 Mario Bendersky, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 24 June 2021 | Accepted: 01 September 2021 | Published: 10 September 2021
Keywords: arterial stifness; spironolactone
Abstract
Background: In previous studies we demonstrated that spironolactone 50 mg OD, added in hypertensive patients who do not normalize pressure with enalapril 10 mg in the morning, after 3 months reduces pressure and reduces arterial stiffness.
Introduction
The objective of the present study was to analyze if this effect lasted up to 6 months, in a larger group of hypertensive patients. ABPM allows us to obtain Ambulatory Arterial Stiffness Index (AASI) through a mathematical formula. This index correlates well with Pulse Wave Velocity (PWV) and has shown good prognostic value in both normo and hypertensive populations: high AASI values, worse CV prognosis.
Hypertensives have shown increased arterial stiffness.
Enalapril (E) 10 mg in the morning is the commonest initial treatment in Argentine. After 30 days, in resistant to E hypertensives, it is used to add a second drug. Spironolactone (S) has antifibrotic properties, and has not enough studied in hypertensives in a short term treatment. Because these fact, we analize the effect of S add to E on AASI in patients with stage 1 essential hypertension treated 6 months with OD morning doses.
Materials and Methods
104 essential stage I hypertensives on E 10 mg at least 30 days were added with S: Aldo:Renine score <30>135 and/or 85 mmHg Mean age 64.2 years (54-68), 66 were male, BMI 29.3 (25-30). We added S 50 mg/d in OD morning dose for 6 months. Two 24-hour ABPM recordings (Spacelabs 90207) were performed pre and post-S, with at least 70 valid measurements each. A paired T-Test was used for statistical analysis and P<0>
Results
Adverse events were mild, 18patients suffered headaches, kalemia increased from 4.10 to 4.50 mEq/l, and creatinine from 9.10 to 9.40 mg%, 6 patients presented mild dry cough.
Conclusion
In a basal study (E treated) AASI values were high (normal values are expected less then 0, 40 for this age) Spironolactone added to E, 50mg OD in the morning, during 6 months, induced a significant office and ambulatory BP decrease, and tends to reduce BP variability and heart rate. AASI was reduced to 0.36, within normal values, after 6 months of treatment.
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