PMID: 16613101Apr 15, 2006Paper

Use of spironolactone and indapamide in the treatment of low-renin arterial hypertension

Terapevticheskiĭ arkhiv
A NaudzhunasG Kazanavichus

Abstract

To compare efficacy of use of the blocker of aldosteron receptors spironolactone and diuretic indapamide in low-renin arterial hypertension (AH), their action on blood pressure, serum concentrations of sodium, potassium, creatinine, plasmic renin activity (PRA), plasmic aldosteron concentration (PAC). The study included 31 females aged 40-60 years with hardly correctable AH and high PAC to (PRA) ratio. Biochemical parameters were measured before 2-week treatment with indapamide (1.5 mg/day) and spironolactone (25 mg/day) and after the treatment. Between the courses there was a 2-week interval. In AH patients with high PAC/PRA spironolacton reduced AP more significantly (-15.5 / -8.2 mmHg) than indapamide (-10.9 / -5.9 mmHg). Indapamide lowered potassium serum levels by 0.28 mmol/l (p < 0.05), spironolacton raised it by 0.26 mmol/l (p = 0.05). Sodium concentration in the serum reduced only after treatment with spironolactone. Both drugs increased blood concentrations of creatinine, aldosteron, PRA, but spironolactone was more active. In treatment-resistant AH it is necessary to perform screening for detection of patients with low-renin hypertension. Such patients are effectively treated with spironolacton in low doses.

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