Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy
The literature review is devoted to modern ideas about the role of hyperaldosteronism as one of the important pathophysiological links in hypertension (HTN) development. Data are presented on aldosterone synthesis mechanisms both in healthy and sick people, in particular in primary aldosteronism (PA...
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| Format: | Article |
| Language: | English |
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Столичная издательская компания
2023-10-01
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| Series: | Рациональная фармакотерапия в кардиологии |
| Subjects: | |
| Online Access: | https://www.rpcardio.online/jour/article/view/2918 |
| _version_ | 1826949532335734784 |
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| author | S. R. Gilyarevsky D. O. Ladygina |
| author_facet | S. R. Gilyarevsky D. O. Ladygina |
| author_sort | S. R. Gilyarevsky |
| collection | DOAJ |
| description | The literature review is devoted to modern ideas about the role of hyperaldosteronism as one of the important pathophysiological links in hypertension (HTN) development. Data are presented on aldosterone synthesis mechanisms both in healthy and sick people, in particular in primary aldosteronism (PA), as well as in some cases of secondary aldosteronism. The results of modern studies are discussed, which established autonomous formation of aldosterone in elderly and senile people even without formal criteria for PA. The most important stages of studying and solving the hyperaldosteronism problem using surgical or conservative methods areconsidered. Data are presented on target organ damage caused by an increased blood concentration of aldosterone. The influence of the interaction between increased dietary sodium intake and the severity of cardiovascular damage is discussed. Separately, the role of subclinical hyperaldosteronism in the development of hypertension is considered, as well as the possibility of target organ damage in such cases, despite the normal blood pressure level. Modern data on the role of mineralocorticoid receptor antagonists (MRAs), in particular spironolactone, in the treatment of hyperaldosteronism and resistant hypertension are presented. The limitations of MRA use, which are mainly due to reduced kidney function, are considered. In particular, the results of the most important clinical studies are discussed, which became the basis for higher prescription rate of MRAs in the treatment of hypertensive patients. |
| first_indexed | 2024-03-08T14:00:22Z |
| format | Article |
| id | doaj.art-ac3981969d3a401da96faf1576942b85 |
| institution | Directory Open Access Journal |
| issn | 1819-6446 2225-3653 |
| language | English |
| last_indexed | 2025-02-17T22:15:20Z |
| publishDate | 2023-10-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj.art-ac3981969d3a401da96faf1576942b852024-12-04T11:48:22ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532023-10-0119440341210.20996/10.20996/1819-6446-2023-29182132Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapyS. R. Gilyarevsky0D. O. Ladygina1Russian Medical Academy of Continuous Professional EducationI. M. Sechenov First Moscow State Medical UniversityThe literature review is devoted to modern ideas about the role of hyperaldosteronism as one of the important pathophysiological links in hypertension (HTN) development. Data are presented on aldosterone synthesis mechanisms both in healthy and sick people, in particular in primary aldosteronism (PA), as well as in some cases of secondary aldosteronism. The results of modern studies are discussed, which established autonomous formation of aldosterone in elderly and senile people even without formal criteria for PA. The most important stages of studying and solving the hyperaldosteronism problem using surgical or conservative methods areconsidered. Data are presented on target organ damage caused by an increased blood concentration of aldosterone. The influence of the interaction between increased dietary sodium intake and the severity of cardiovascular damage is discussed. Separately, the role of subclinical hyperaldosteronism in the development of hypertension is considered, as well as the possibility of target organ damage in such cases, despite the normal blood pressure level. Modern data on the role of mineralocorticoid receptor antagonists (MRAs), in particular spironolactone, in the treatment of hyperaldosteronism and resistant hypertension are presented. The limitations of MRA use, which are mainly due to reduced kidney function, are considered. In particular, the results of the most important clinical studies are discussed, which became the basis for higher prescription rate of MRAs in the treatment of hypertensive patients.https://www.rpcardio.online/jour/article/view/2918hyperaldosteronismhypertensionresistant hypertensionmineralocorticoid receptor antagonistsspironolactone |
| spellingShingle | S. R. Gilyarevsky D. O. Ladygina Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy Рациональная фармакотерапия в кардиологии hyperaldosteronism hypertension resistant hypertension mineralocorticoid receptor antagonists spironolactone |
| title | Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| title_full | Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| title_fullStr | Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| title_full_unstemmed | Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| title_short | Paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| title_sort | paradigm shift on the role of mineralocorticoid receptor antagonists in hypertension therapy |
| topic | hyperaldosteronism hypertension resistant hypertension mineralocorticoid receptor antagonists spironolactone |
| url | https://www.rpcardio.online/jour/article/view/2918 |
| work_keys_str_mv | AT srgilyarevsky paradigmshiftontheroleofmineralocorticoidreceptorantagonistsinhypertensiontherapy AT doladygina paradigmshiftontheroleofmineralocorticoidreceptorantagonistsinhypertensiontherapy |