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• W1982169148 endingPage "2044" @default.
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• W1982169148 abstract "Objectives: We report the results of an echocardiographic substudy carried out in a trial comparing the effects of two different treatment strategies – mineralocorticoid receptor blockade (MRB) and dual renin–angiotensin system blockade (RASB) – in patients with resistant hypertension. Both strategies reduce left ventricular mass index (LVMI), but they have not been compared in patients with resistant hypertension. Methods: After 4-week treatment with 300 mg irbesartan + 12.5 mg hydrochorothiazide + 5 mg amlodipine, 86 patients with resistant hypertension were randomized to the add-on 25 mg spironolactone (MRB group, n = 46) or 5 mg ramipril (RASB group, n = 40) groups for 12 weeks. Treatment intensity was increased at week 4, 8 or 10 if home blood pressure (BP) was equal to or above 135/85 mmHg, by sequentially adding 20–40 mg furosemide and 5 mg amiloride (MRB group), or 10 mg ramipril and 5–10 mg bisoprolol (RASB group). Transthoracic echography was performed at baseline and week 12. Results: Daytime ambulatory BP decreased by 19 ± 12/11 ± 8 mmHg in the MRB group and by 8 ± 13/7 ± 7 mmHg in the RASB group (P = 0.0003/0.03). LVMI decreased by 8.2 ± 18.9 g/m2 in the MRB group, whereas it increased by 1.8 ± 19.1 g/m2 in the RASB group (P = 0.03). The decreases in posterior wall thickness, left ventricular (LV) end-systolic diameter, E/e′ ratio and left atrial area were significantly greater with MRB than with RASB. The difference between groups remained significant after adjustment for the decrease in ambulatory BP. Conclusion: In patients with resistant hypertension, MRB-based treatment decreased both BP and LVMI more efficiently than a strategy based on dual RASB." @default.
• W1982169148 created "2016-06-24" @default.
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• W1982169148 date "2014-10-01" @default.
• W1982169148 modified "2023-09-30" @default.
• W1982169148 title "Greater efficacy of aldosterone blockade and diuretic reinforcement vs. dual renin–angiotensin blockade for left ventricular mass regression in patients with resistant hypertension" @default.
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• W1982169148 doi "https://doi.org/10.1097/hjh.0000000000000280" @default.
• W1982169148 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/24983187" @default.
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