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Idiopathic primary hyperaldosteronism: normalization of plasma aldosterone after one month withdrawal of long-term therapy with aldosterone-receptor antagonist potassium canrenoate.

Abstract
We have re-evaluated 15 patients with idiopathic primary aldosteronism one month after withdrawal of therapy with aldosterone-receptor antagonist potassium canrenoate. Therapy had lasted for 3 to 24 yr. Median blood pressure (BP) in the sitting position at the time of diagnosis was 160/100 (ranges 150-200/95-110 mmHg); while 1 month after withdrawal of therapy median BP was 145/90 (ranges 125-160/80-100 mmHg). One month after withdrawal, the ratio aldosterone (ng/dl)/plasma renin activity (ng/ml/h) in the upright position was increased only in 3 cases (median 18, range 6.1-125). We found a significant inverse correlation between the upright aldosterone/plasma renin activity (aldo/PRA) ratio, 1 month after withdrawal, and the number of years of therapy with potassium canrenoate. We conclude that long-term therapy with the aldosterone-receptor blocker, potassium canrenoate, can normalize the aldo/PRA ratio in many cases of idiopathic primary hyperaldosteronism after one-month withdrawal of the drug. These data are consistent with possible regression of idiopathic primary hyperaldosteronism after long-term therapy with potassium canrenoate, or in alternative to a persistent effect of potassium canrenoate, on aldosterone synthesis.
AuthorsD Armanini, C Scaroni, M J Mattarello, C Fiore, N Albiger, P Sartorato
JournalJournal of endocrinological investigation (J Endocrinol Invest) Vol. 28 Issue 3 Pg. 236-40 (Mar 2005) ISSN: 0391-4097 [Print] Italy
PMID15952408 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Electrolytes
  • Mineralocorticoid Receptor Antagonists
  • Aldosterone
  • Canrenoic Acid
  • Renin
Topics
  • Adult
  • Aldosterone (blood)
  • Blood Pressure (drug effects)
  • Canrenoic Acid (adverse effects, therapeutic use)
  • Electrolytes (blood)
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperaldosteronism (blood, drug therapy, physiopathology)
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists (adverse effects, therapeutic use)
  • Renin (blood)
  • Renin-Angiotensin System (drug effects)

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