gms | German Medical Science

29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Hochdruckliga e. V. DHL ® - Deutsche Hypertonie Gesellschaft Deutsches Kompetenzzentrum Bluthochdruck

23. bis 25.11.2005, Berlin

Spironolactone (25 mg o.d.) Reduces Left Ventricular Mass Without Changing Blood Pressure

Spironolakton (25mg/die) reduziert die linksventrikuläre Masse ohne Effekt auf den Blutdruck

Meeting Abstract

  • B. Schmidt - Universität Erlangen-Nürnberg (Nürnberg, D)
  • A. Schneider - Universität Erlangen-Nürnberg (Nürnberg, D)
  • T. Kalitzki - Universität Erlangen-Nürnberg (Nürnberg, D)
  • A. Rastätter - Universität Erlangen-Nürnberg (Nürnberg, D)
  • T.K. Schwarz - Universität Erlangen-Nürnberg (Nürnberg, D)
  • R.E. Schmieder - Universität Erlangen-Nürnberg (Nürnberg, D)

Hypertonie 2005. 29. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Berlin, 23.-25.11.2005. Düsseldorf, Köln: German Medical Science; 2006. Doc05hochP64

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2005/05hoch064.shtml

Veröffentlicht: 8. August 2006

© 2006 Schmidt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

There is evidence for blood pressure independent effects of aldosterone on left ventricular structure and function. We examined whether a low dose of spironolactone (spiro) that does not lower blood pressure improves parameters of left ventricular structure and function in young male hypertensives.

We conducted a randomized placebo controlled cross-over study in 26 otherwise healthy, young male volunteers with never treated essential hypertension (stage 1 and 2). Patients were treated with spiro 25 mg and placebo for 4 weeks according to the two-fold cross-over design. At the end of each treatment phase ambulatory blood pressure measurement and echocardiography/dopplerechocardiography were performed. Primary endpoint of the study was left ventricular mass index, secondary endpoints were systolic and diastolic left ventricular function.

Treatment with spiro reduced LVMI (114.8 ± 3.9 vs. 106.5 ± 3.3 g/m2 , p=0.018). This difference is based on a decrease in diastolic left ventricular diameter (51.6 ± 0.9 vs. 53.2 ± 0.9 mm, p=0.046) and a decrease in septal wall thickness (9.6 ± 0.2 vs. 9.9 ± 0.3 mm, p=0.142) without a change in left ventricular posterior wall thickness (9.0 ± 0.3 vs. 9.0 ± 0.2 mm, p=0.9). Parameters of left ventricular systolic and diastolic function were unchanged. Mean 24-hour-blood pressure was 129.2 ± 1.2 / 75.3 ± 1.8 mmHg with spiro treatment and 130.3 ± 1.5 / 74.1± 3.0 mmHg with placebo treatment (p=0.358 for systolic and p=0.643 for diastolic blood pressure). There was no difference in sodium and potassium serum levels. Urinary-sodium excretion was increased in the spiro period (226.5 ± 29.2 vs. 206.8 ± 25.8 mmol/24h), whereas potassium excretion was unchanged.

In this study we can show a reduction of left ventricular mass by a short term treatment with a low dose spironolactone without a change in blood pressure. This might be a combined effect of direct action of spiro on cardiac mineralocorticoid receptors together with increased natriuresis.