MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES?
Despite the availability of anti-hypertensive medications with increasing efficacy up to 50% of hypertensive patients have blood pressure levels (BP) not at the goals set by international societies. Some of these patients are either not optimally treated or are non adherent to the prescribed drugs,...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2015-02-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fcvm.2015.00003/full |
| _version_ | 1811306771558432768 |
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| author | Giuseppe eMaiolino Matteo eAzzolini Gian Paolo eRossi |
| author_facet | Giuseppe eMaiolino Matteo eAzzolini Gian Paolo eRossi |
| author_sort | Giuseppe eMaiolino |
| collection | DOAJ |
| description | Despite the availability of anti-hypertensive medications with increasing efficacy up to 50% of hypertensive patients have blood pressure levels (BP) not at the goals set by international societies. Some of these patients are either not optimally treated or are non adherent to the prescribed drugs, however, a relevant proportion, despite adequate treatment, have resistant hypertension (RH), which represents an important problem in that is associated to an excess risk of cardiovascular events. Notwithstanding a complex pathogenesis, an abundance of data suggests a key contribution for the mineralocorticoid receptor in RH, thus fostering a potential role for its antagonists in this field. Based on these premises randomized clinical trials have been completed aimed at testing the efficacy of mineralocorticoid receptor antagonists (MRA)s in RH patients and demonstrated their efficacy in reducing BP and markers of target organ damage, such as microalbuminuria, compared to either placebo or other drugs. In summary, owing to the role of the mineralocorticoid receptors in the pathogenesis of RH and on their efficacy proved by randomized clinical trials we advocate the inclusion of MRAs as a forth line therapy in patients with RH. |
| first_indexed | 2024-04-13T08:51:33Z |
| format | Article |
| id | doaj.art-e1864c240e7e43c2b02ab4a4f141a0ea |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T08:51:33Z |
| publishDate | 2015-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-e1864c240e7e43c2b02ab4a4f141a0ea2022-12-22T02:53:29ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2015-02-01210.3389/fcvm.2015.00003122817MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES?Giuseppe eMaiolino0Matteo eAzzolini1Gian Paolo eRossi2Clinica Medica 4, DIMED, Azienda Ospedaliera di PadovaClinica Medica 4, DIMED, Azienda Ospedaliera di PadovaClinica Medica 4, DIMED, Azienda Ospedaliera di PadovaDespite the availability of anti-hypertensive medications with increasing efficacy up to 50% of hypertensive patients have blood pressure levels (BP) not at the goals set by international societies. Some of these patients are either not optimally treated or are non adherent to the prescribed drugs, however, a relevant proportion, despite adequate treatment, have resistant hypertension (RH), which represents an important problem in that is associated to an excess risk of cardiovascular events. Notwithstanding a complex pathogenesis, an abundance of data suggests a key contribution for the mineralocorticoid receptor in RH, thus fostering a potential role for its antagonists in this field. Based on these premises randomized clinical trials have been completed aimed at testing the efficacy of mineralocorticoid receptor antagonists (MRA)s in RH patients and demonstrated their efficacy in reducing BP and markers of target organ damage, such as microalbuminuria, compared to either placebo or other drugs. In summary, owing to the role of the mineralocorticoid receptors in the pathogenesis of RH and on their efficacy proved by randomized clinical trials we advocate the inclusion of MRAs as a forth line therapy in patients with RH.http://journal.frontiersin.org/Journal/10.3389/fcvm.2015.00003/fulltherapyPathogenesisreviewResistant hypertensionMineralocorticoid Receptor Antagonists |
| spellingShingle | Giuseppe eMaiolino Matteo eAzzolini Gian Paolo eRossi MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? Frontiers in Cardiovascular Medicine therapy Pathogenesis review Resistant hypertension Mineralocorticoid Receptor Antagonists |
| title | MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? |
| title_full | MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? |
| title_fullStr | MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? |
| title_full_unstemmed | MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? |
| title_short | MINERALOCORTICOID RECEPTOR ANTAGONISTS THERAPY IN RESISTANT HYPERTENSION: TIME TO IMPLEMENT NEW GUIDELINES? |
| title_sort | mineralocorticoid receptor antagonists therapy in resistant hypertension time to implement new guidelines |
| topic | therapy Pathogenesis review Resistant hypertension Mineralocorticoid Receptor Antagonists |
| url | http://journal.frontiersin.org/Journal/10.3389/fcvm.2015.00003/full |
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