Aldosterone breakthrough during angiotensin-converting enzyme inhibitor therapy

Sato, Aiko

doi:10.1016/s0895-7061(03)00913-0

Cited by 113 publications

(76 citation statements)

References 60 publications

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“…Plasma aldosterone was not decreased. 19,20 Treatment did not affect 24-hour sodium excretion, clearance of sodium, or renal tubular sodium handling measured by lithium clearance (Table S2). Hematocrit and hemoglobin were decreased by about 5% in the candesartan treated group at month 12 21 (Table S2).…”

Section: Interventionmentioning

confidence: 98%

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

et al. 2007

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Abstract-Offspring of hypertensive parents are at high risk of future hypertension and subsequent cardiovascular diseases.We investigated whether early treatment with an angiotensin-receptor blocker in young normotensive offspring of hypertensive parents persistently lowered blood pressure after treatment withdrawal, a possibility supported by animal studies. The study is an investigator-initiated, double-blind study of 110 healthy normotensive subjects aged 18 to 36 years where both parents have essential hypertension randomly assigned to 1 of 2 treatment groups: candesartan (Atacand, Astra Zeneca), 16 mg o.d. or placebo. The intervention period was 12 months, with 24 months of follow-up. Primary outcome was mean 24-hour ambulatory blood pressure recordings (mean AMBP) after 12 and 24 months follow-up and was based on intention to treat (nϭ110). Secondary outcomes were changes during treatment in mean AMBP, left ventricular mass, renal hemodynamics, and adverse events during intervention and were based on those completing the intervention period (nϭ105). Primary outcome: At 12 and 24 months follow-up, mean AMBP was not different to placebo. Secondary outcomes: After 12 months of intervention, mean AMBP was reduced: Ϫ3.9/ Ϫ3.4 mm Hg for candesartan versus 0.3/0.6 mm Hg for placebo, PϽ0.0001. Renal vascular resistance and left ventricular mass were also reduced (Pϭ0.0007, Pϭ0.019, respectively). There were no significant differences in adverse advents between the 2 groups. In conclusion, temporary treatment of subjects at high familial risk of future hypertension with an angiotensin receptor blocker is feasible, but the treatment had no persistent effect on blood pressure when treatment was withdrawn. H uman essential hypertension remains the most common risk factor for cardiovascular morbidity and mortality. 1 Preventing or delaying the onset of the disease may therefore have large impact on public health. Such treatment should be directed toward normotensive persons likely to develop hypertension, for which at least 2 major populations can be identified: those who have blood pressures in the upper part of the normotensive range and those who have hypertensive parents. Both these populations have at least a 50% chance of developing hypertension, and each (not mutually exclusive) constitute 10 to 20% of most Western societies. 2 The recently published Trial Of Prevention HYpertension (TROPHY) study 3 has studied this question in the first population, and reported that treatment of subjects with high-normal blood pressure (prehypertensives, eg, blood pressure 130 to 139/85 to 89 mm Hg) with an angiotensin-receptor blocker, candesartan, can delay the onset of hypertension. The result is remarkable, 4 but has also been criticized. 5,6 The present study (Danish Hypertension Prevention Project [DHyPP]) concerns the second population. 7 The study is based on the consistent reports from genetic rat models of essential hypertension that short-term inhibition of the reninangiotensin system has persistent effects on blood ...

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Section: Interventionmentioning

confidence: 98%

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

et al. 2007

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“…Aldosterone has detrimental effects on the cardiovascular system and synergizes with angiotensin II to increase blood pressure and produce cardiovascular remodeling and hypertrophy. Thus, combined treatment of aldosterone synthesis blockers and ACE inhibitors is reported to be more successful in treating cardiovascular disorders Sato & Saruta, 2003).…”

Section: Definitionmentioning

confidence: 99%

Anger-In

Abrams¹,

Witkiewitz²,

Fulmer³

et al. 2013

Encyclopedia of Behavioral Medicine

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“…With angiotensin-converting enzyme inhibitors (ACE-I), aldosterone, which had decreased, is increased by the long-term administration (aldosterone breakthrough), 8) and the same cases are also observed with ARB. 9) Yoneda et al reported that this occurred in 23% of cases given candesartan.…”

Section: Introductionmentioning

confidence: 99%

Effects of Olmesartan on the Renin-angiotensin-aldosterone System for Patients with Essential Hypertension after Cardiac Surgery—Investigation Using a Candesartan Change-over Study—

Sezai

Soma

Hata

et al. 2011

ATCS

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Background: Various angiotensin II receptor blockers are widely used for the treatment of hypertension in recent years. The results of large-scale clinical studies have shown that they have various efficacies: not only hypotensive effects but also organ protective effects. In this study, the effects of a change-over from candesartan to olmesartan on renin-angiotensin-aldsterone system, cardiomegaly and peripheral circulation were studied. Methods: Participants enrolled in this trial were outpatients with essential hypertension after cardiac surgery who had received candesartan for more than one year. Fifty-six patients switched from candesartan to olmesartan. The primary endpoints were 1) renin activity, angiotensin II, aldosterone, and 2) left ventricular mass index (LVMI). Results: It was clear that angiotensin II and aldosterone are decreased by the potent hypotensive effects of olmesartan in a change-over from candesartan to olmesartan. Since LVMI and BNP were decreased, inhibitory effects on myocardial hypertrophy were also confirmed. Conclusion: In the present study, left ventricular hypertrophy and on arterial compliance were inhibited by a decrease in angiotensin II and aldosterone due to the change-over to olmesartan. In the future, protective effects on organs will be clarified by long-term observations.

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Aldosterone breakthrough during angiotensin-converting enzyme inhibitor therapy

Cited by 113 publications

References 60 publications

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

Anger-In

Effects of Olmesartan on the Renin-angiotensin-aldosterone System for Patients with Essential Hypertension after Cardiac Surgery—Investigation Using a Candesartan Change-over Study—

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