Efficacy of an angiotensin II receptor antagonist in managing hyperaldosteronism

Gordon S. Stokes, Judith C. Monaghan, Mary Ryan, Mark Woodward

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To determine whether an angiotensin II receptor antagonist decreases blood pressure in patients with hyperaldosteronism and hypertension who are taking other antihypertensive agents. Design A double-blind randomized placebo-controlled crossover study. Patients and methods Blood pressure and hormonal responses to 2-week courses of placebo/irbesartan (150 mg/day given by mouth at 08.05 h) were assessed in 10 patients with hyperaldosteronism. Clinic blood pressure was measured by sphygmomanometer, and plasma concentrations of aldosterone, cortisol, angiotensin II, electrolytes and renin activity (PRA) were determined weekly. Automated 24 h ambulatory blood pressure recordings were made at the end of the active and placebo phases. Results Irbesartan caused a post-dose decrease in ambulatory blood pressure (systolic, P = 0.02; diastolic, P = 0.05) in the period from 10.00 h to 20.00 h. Clinic blood pressure, measured at trough, was not significantly decreased. Plasma aldosterone decreased (P < 0.03) and PRA increased (P<0.04) in the first week of active treatment with irbesartan, but differences between the placebo and active-treatment groups were not significant in the second week. There were no significant changes in plasma concentrations of angiotensin II, cortisol or potassium in either week. In the second week of irbesartan treatment, there were associations between change in plasma aldosterone and maximal change in ambulatory blood pressure (systolic and diastolic). Conclusion Irbesartan has a role in combination antihypertensive treatment of patients with hyperaldosteronism.

Original languageEnglish (US)
Pages (from-to)1161-1165
Number of pages5
JournalJournal of hypertension
Volume19
Issue number6
DOIs
StatePublished - Jan 1 2001

Keywords

  • Angiotensin II receptor antagonists
  • Hyperaldosteronism
  • Hypertension, ambulatory blood pressure recording
  • Irbesartan
  • Spironolactone

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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