Abstract:
OBJECTIVES:We hypothesized that the aldosterone: renin ratio (ARR) predicts the antihypertensive response to mineralocorticoid receptor antagonist, spironolactone (SPIRO), when compared with bendroflumethiazide (BFZ). METHODS:We conducted a randomized, crossover, trial on hypertensive patients with either high ARR (HARR defined as >750 and plasma aldosterone >250 pmol/l) or low ARR (LARR defined as <300 and plasma renin activity <10 ng/ml per h). Each group took SPIRO 50 mg once daily for 12 weeks and BFZ 2.5 mg once daily for 12 weeks in random order separated by 2-week washout. Patients with mean 24-h systolic ambulatory blood pressure (SABP) at least 140 mmHg were included. Primary endpoint was difference in SABP between SPIRO and BFZ in patients with HARR compared with those with LARR. RESULTS:One hundred and eleven patients (60 HARR and 51 LARR) completed the study. SABP at 12 weeks in the HARR group was 129.4 mmHg on SPIRO and 134.4 mmHg on BFZ [difference -5.01; 95% confidence interval (CI) -7.51, -2.52; P < 0.0002]. In the LARR group, SABP was 129.7 mmHg on SPIRO and 133.1 mmHg on BFZ [difference -3.43 (95% CI -6.18, -0.68) P < 0.01]. Difference between groups (HARR vs. LARR) was -1.58 mmHg (95% CI 5.25, -2.08; not significant, P = 0.394). In a secondary analysis of the overall study population of 111 patients, SABP reduction with SPIRO 50 mg was superior to BFZ 2.5 mg [SPIRO -14.8 mmHg, BFZ -10.5 mmHg, difference -4.29 mmHg (95% CI -6.12, -2.46)]. Results were similar for secondary endpoints. Plasma renin activity or aldosterone did not predict blood pressure response to SPIRO. Results were independent of concomitant angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use. CONCLUSION:The ARR did not predict the blood pressure response to SPIRO. SPIRO 50 mg was significantly more effective than BFZ 2.5 mg in lowering SABP irrespective of baseline ARR, plasma renin activity or aldosterone.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Parthasarathy HK,Alhashmi K,McMahon AD,Struthers AD,McInnes GT,Ford I,Connell JM,MacDonald TMdoi
10.1097/HJH.0b013e328332b79bsubject
Has Abstractpub_date
2010-01-01 00:00:00pages
170-7issue
1eissn
0263-6352issn
1473-5598journal_volume
28pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVES:Sodium is the mineral that has been, mainly, linked to hypertension and cardiovascular disease. It is found naturally in many foods, but is also used in the food industry and manufacturing. Identification of total sodium intake, as well as 'hidden' sodium intake from food sources early in life is necessary. ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328345ef35
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To investigate the rate of albumin excretion and the prevalence of albuminuria in hypertensive individuals relative to the normotensive population, and to clarify the quantitative importance of confounding variables. DESIGN AND METHODS:We examined the morning urines of all consecutive non-diabetic and diabet...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199605000-00016
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:The acute effects of estrogen on hemodynamic responses were studied with emphasis on the sympathoadrenal system and peripheral circulation. DESIGN:Eleven healthy postmenopausal women recruited from the population-based study BEDA were included in this randomized, double-blind, cross-over, placebo-controlled ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200302000-00031
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To measure blood pressure accurately, by developing a new algorithm and an indirect method employing a non-elastic cuff with a photosensor. DESIGN AND METHODS:A non-elastic cuff was wrapped around the brachium. A reflecting plate (10 mm x 40 mm) was sited on the inner central part of the cuff on the arterial...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715020-00005
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVES:Genetic variants that influence large conductance calcium-activated potassium channel's function may alter arterial function and contribute to the known heritability of arterial stiffness and blood pressure. The beta1-subunit (KCNMB1) of the large conductance calcium-activated potassium channel includes two ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328317c8ae
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify the time of blood pressure (BP) drop in the orthostatic hypotension test, and to propose a realistic and appropriate duration in the orthostatic hypotension test. METHODS:A total of 879 consecutive patients (61-year-old and 44% women) with positive on the orthostatic...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002554
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Recent studies have shown that the heptapeptide angiotensin-(1-7) [Ang-(1-7)] exerts important vasoactive actions and can act as an endogenous physiological antagonist of angiotensin II (Ang II) within the renin-angiotensin system (RAS). The present study was performed to evaluate the effects, first, of chron...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32832f0d06
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVES:To discuss changes during the past decades in the prevalence and in the patterns of detection, treatment and control of arterial hypertension in the general Belgian population aged 25-64 years. DESIGN:Data from two cross-sectional cardiovascular disease risk factor surveys of the general population aged 25-...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816030-00004
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To assess the effects of acute exposure to simulated high altitude on baroreflex control of mean cerebral blood flow velocity (MCFV). PATIENTS AND METHODS:We compared beat-to-beat changes in RR interval, arterial blood pressure, mean MCFV (by transcranial Doppler velocimetry in the middle cerebral artery), e...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32826f49a3
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:The existence and localization of renin in situ was examined in human arteries under non-pathological conditions. DESIGN:Biochemical and immunohistochemical procedures were adopted to examine the existence of renin in human gastroepiploic arteries using an antibody raised against human recombinant renin or a...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199201000-00008
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:We compared the agreement between different techniques to estimate central SBP (cSBP) in children and the relative impact of different methods of measuring peripheral blood pressure (BP). METHODS:A total of 135 children, aged 12.9 ± 3.0 years including 67 boys, 85 with chronic kidney disease were studied. W...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002172
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Currently, normative means and ranges of blood pressure (BP) and pulse rates in Japanese newborns are not available. The objective of the present study was to estimate BP, pulse rate, and their distribution among Japanese newborns. METHODS:Using oscillometric devices, arm or calf BP and pulse rate levels wer...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000976
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To investigate the role of ouabain in human hypertension and to establish whether immunoreactive endogenous ouabain is secreted by the adrenal gland under the influence of dopaminergic regulation. METHODS:We measured plasma levels of endogenous ouabain by immunoassay, together with other variables, including...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199510000-00013
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVES:Human adrenomedullin precursor is converted to glycine-extended adrenomedullin (AM-Gly), an intermediate inactive form of adrenomedullin. Subsequently, AM-Gly is converted to active form of mature adrenomedullin (AM-m). The aim of the present study was to investigate (i) whether sex or age influences plasma ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200104000-00014
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:We tested the reproducibility of ambulatory blood pressure (ABP), BP variability, and BP reduction in hypertensive patients. METHODS:Forty-two hypertensive patients were enrolled, and ABP monitoring (ABPM) was performed four times in each patient: twice before and twice after the treatment. Morning BP was de...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283378477
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To determine the long-term efficacy and safety of a fixed, very-low-dose tablet combining one-half the standard dose of perindopril with one-quarter the standard dose of indapamide as first-line treatment in elderly patients. DESIGN:Double-blind, randomized, placebo-controlled study in an outpatient setting....
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00004872-200018030-00013
更新日期:2000-03-01 00:00:00
abstract::The hormonal and hypotensive effects of a single oral 10 mg dose of enalapril (MK-421), were assessed by a double-blind randomized trial in 12 subjects with essential hypertension, during a 100 and 40 mmol/day sodium intake. Peak serum MK-421 appeared 1 h following oral dosage. The bioactive conversion product of MK-4...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Atrial natriuretic peptide (ANP) plays a pivotal role in modulation of vascular function and it is also involved in the pathophysiology of several cardiovascular diseases. We provide an updated overview of the current appraisal of ANP vascular effects in both animal models and humans. We describe the physiological imp...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e32835ed5eb
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To assess the trends in blood pressure (BP) and in body mass index (BMI) in the hypertensive and normotensive population in Finland during 1982-1997. DESIGN:Four independent cross-sectional standardized population surveys were conducted in 1982, 1987, 1992 and 1997. SETTING:The provinces of North Karelia an...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018030-00003
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:Remodeling of small resistance arteries is an early sign of target organ damage in hypertension. Peripheral capillary morphology abnormalities in hypertension are not well studied. The study objective was to determine whether altered capillary morphology is associated with SBP, DBP, or both in individuals wi...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833e113b
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:Whether the C-344T polymorphism of the aldosterone synthase gene is important for blood pressure control remains controversial. It has been proposed that an association between this polymorphism and blood pressure might be evident in elderly subjects. The aim of the present study was to test this hypothesis ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000183119.92455.a7
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to define the relationship between physical activity and the magnitude of the percentage fall in blood pressure at night (nocturnal dip). METHODS:We simultaneously monitored 24-h ambulatory blood pressure and measured physical activity by actigraphy in 434 patients. Blood pressure w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018040-00008
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:The contribution of salt intake to the pathogenesis of hypertension holds longstanding interest. Recent studies employed the sensitivity of blood pressure (BP) to salt intake as an intermediate phenotype. The validity of this approach relative to the homogeneity of sodium-sensitive hypertension was investigat...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1097/00004872-200305000-00020
更新日期:2003-05-01 00:00:00
abstract::Recently, there has been an explosion of knowledge on vasopressin, including its neuro-anatomy, biochemistry and physiology. Recent work demonstrates extensive extra-hypothalamic vasopressinergic projections from the SON and PVN. Of particular importance are projections to the cardiovascular medullary centres. Convers...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-198512000-00001
更新日期:1985-12-01 00:00:00
abstract::Fenoldopam, a dopamine-1 (D1) agonist, was administered by a 6-h intravenous infusion to patients with refractory hypertension [diastolic blood pressure (DBP) greater than 115 mmHg while on triple therapy] in order to achieve a fall in DBP of 30 mmHg. The evolution of blood pressure, heart rate, glomerular filtration ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198808000-00010
更新日期:1988-08-01 00:00:00
abstract::Behavioral stress and high dietary salt have been reported to increase blood pressure additively in non-human primates. This study was designed to replicate this phenomenon and to assess neuroendocrine correlates and responses to two commonly used antihypertensives, a beta-adrenoceptor blocker and a thiazide diuretic....
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVE:To examine in a population with a high prevalence of hypertension, the association between six cardiovascular polymorphisms, arterial stiffness and medication use. METHODS:In this cross-sectional study (Hypertension: Interaction and Prevalence of POlymorphisms related to Cardiovascular Risk and the Associati...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/hjh.0b013e328317f215
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether antioxidant therapy could relieve hypertension and retard the progression of renal damage in advanced-stage hypertensive rats. METHODS:Twenty-four-week-old spontaneously hypertensive stroke-prone rats were treated for 8 weeks with the superoxide dismutase mimeti...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000064
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Metabolic syndrome (MetS) is associated with uncontrolled blood pressure (BP), despite use of aggressive therapy. This study was performed to assess whether the use of different classes of antihypertensive drugs might influence this association. METHODS:We evaluated risk of uncontrolled BP (BP ≥ 140/90 mmHg ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834e1eda
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Few data are available comparing the effects of monotherapy and combination therapy on target organ damage. The PICXEL study compared the efficacy of a strategy based on first-line combination with perindopril/indapamide versus monotherapy with enalapril in reducing left ventricular hypertrophy (LVH) in hyper...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.hjh.0000187253.35245.dc
更新日期:2005-11-01 00:00:00