Endocrine and Haemodynamic Changes in Resistant Hypertension, and Blood Pressure Responses to Spironolactone or Amiloride: the PATHWAY-2 Mechanisms Substudies

Abstract/Summary:

In the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension. Our results suggest that resistant hypertension is commonly a salt-retaining state, most likely due to inappropriate aldosterone secretion. Mineralocorticoid receptor blockade by spironolactone overcomes the salt retention and resistance of hypertension to treatment. Amiloride seems to be as effective an antihypertensive as spironolactone, offering a substitute treatment for resistant hypertension.

Authors: Bryan Williams, Thomas M MacDonald, Steve V Morant, David J Webb, Peter Sever, Gordon T McInnes, Ian Ford, J Kennedy Cruickshank, Mark J Caulfield, Sandosh Padmanabhan, Isla S Mackenzie, Jackie Salsbury, Morris J Brown
Keywords: spironolactone, amiloride, resistant hypertension
DOI Number: 10.1016/s2213-8587(18)30071-8      Publication Year: 2018

To search for other research papers by topic, keyword, author, or year, please go to our Publications page.

©2021 Primary Aldosteronism Foundation — All Rights Reserved

The Primary Aldosteronism Foundation is a registered 501(c)(3) public charity. Donations are tax deductible in the US.

©2021 Primary Aldosteronism Foundation

The Primary Aldosteronism Foundation is a registered 501(c)(3) public charity. Donations are tax deductible in the US.