Key result
ACE inhibitors should be discouraged in patients with primary aldosteronism because they are unable to lower blood pressure in the setting of low renin levels.
Why the study?
Are ACE inhibitors effective for blood pressure reduction in patients with hypertension due to primary aldosteronism?
Are ACE inhibitors effective for blood pressure reduction in patients with hypertension due to primary aldosteronism?
Answers are grounded in this paper and cite their sources.
The use of ACE inhibitors in patients with primary aldosteronism is discouraged due to their inability to lower blood pressure in the setting of low renin levels.
Aldosterone antagonists are the mainstay of therapy in patients with hypertension due to primary aldosteronism. However, in our experience, these patients are sometimes placed on angiotensin-converting enzyme (ACE) inhibitors in accordance with guidelines applying to the general hypertensive population. We believe this practice is inappropriate because of the inability of ACE inhibitors to lower blood pressure in patients with low renin levels. Furthermore, pleiotropic effects of ACE inhibitors are unlikely to provide significant benefits in the absence of blood pressure reduction. Therefore, ACE inhibitors should be discouraged for the majority of patients with primary aldosteronism, even in the face of renal or cardiac disease.
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Bubbar et al. (2006) conducted an editorial in Hypertension due to primary aldosteronism. Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin Receptor Blockers was evaluated. ACE inhibitors should be discouraged in patients with primary aldosteronism because they are unable to lower blood pressure in the setting of low renin levels.
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