Why the study?
Does treatment with hydrochlorothiazide or RAAS blockade cause aldosterone escape in patients with mild to moderate hypertension?
Does treatment with hydrochlorothiazide or RAAS blockade cause aldosterone escape in patients with mild to moderate hypertension?
Therapy with hydrochlorothiazide or combined irbesartan and quinapril for 12 weeks induces early aldosterone escape in patients with mild to moderate hypertension.
May indicate early aldosterone escape with these agents in mild hypertension; leaves open effects on long-term outcomes.
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 aldoster-one 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.
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Ubaid‐Girioli et al. (2007) studied this question.
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