The incidence of left ventricular hypertrophy (LVH) in primary aldosteronism (PA) is higher than in essential hypertension. LVH is an independent cardiovascular risk factor. Treatment of PA with mineralocorticoid receptor blockers (MRBs) improves LVH. Previous studies included relatively small groups, low incidence of LVH and used high MRB dose. We tested the hypothesis that long-term regression of LVH in PA/low-renin hypertension may be achieved with low-dose MRB. Forty-eight patients (male/female 28/20, age 61.4 years, range 47–84) had PA (low renin, high aldosterone and high aldosterone/renin ratio, n = 24) or low-renin hypertension (low renin, normal aldosterone and high aldosterone/renin ratio, n = 24). All had either LVH or concentric remodeling. All had an echocardiogram both at baseline and at 1 year after the initiation of spironolactone. A subgroup of 29 patients had an echocardiogram at baseline, 1 year (range 0.5–1.5) and 3 years (range 1.8–7). In patients with PA/low-renin hypertension, long-term regression of LVH may be achieved with low-dose MRB.

Authors: Yaacov Ori, Avry Chagnac, Asher Korzets, Boris Zingerman, Michal Herman-Edelstein, Michael Bergman, Uzi Gafter, Hertzel Salman
Keywords: primary aldosteronism, left ventricular hypertrophy (LVH)
DOI Number: 10.1093/ndt/gfs587      Publication Year: 2011

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