title: Idiopathic primary hyperaldosteronism: normalization of plasma aldosterone after one month withdrawal of long-term therapy with aldosterone-receptor antagonist potassium canrenoate.
abstract: We have re-evaluated 15 patients with idiopathic primary aldosteronism one month after withdrawal of therapy with aldosterone-receptor antagonist potassium canrenoate. Therapy had lasted for 3 to 24 yr. Median blood pressure (BP) in the sitting position at the time of diagnosis was 160/100 (ranges 150-200/95-110 mmHg); while 1 month after withdrawal of therapy median BP was 145/90 (ranges 125-160/80-100 mmHg). One month after withdrawal, the ratio aldosterone (ng/dl)/plasma renin activity (ng/ml/h) in the upright position was increased only in 3 cases (median 18, range 6.1-125). We found a significant inverse correlation between the upright aldosterone/plasma renin activity (aldo/PRA) ratio, 1 month after withdrawal, and the number of years of therapy with potassium canrenoate. We conclude that long-term therapy with the aldosterone-receptor blocker, potassium canrenoate, can normalize the aldo/PRA ratio in many cases of idiopathic primary hyperaldosteronism after one-month withdrawal of the drug. These data are consistent with possible regression of idiopathic primary hyperaldosteronism after long-term therapy with potassium canrenoate, or in alternative to a persistent effect of potassium canrenoate, on aldosterone synthesis.
authors.affiliation: Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Padua, Italy. decio.armanini@unipd.it
authors.forename: D
authors.initials: D
authors.lastname: Armanini
authors.forename: C
authors.initials: C
authors.lastname: Scaroni
authors.forename: M J
authors.initials: MJ
authors.lastname: Mattarello
authors.forename: C
authors.initials: C
authors.lastname: Fiore
authors.forename: N
authors.initials: N
authors.lastname: Albiger
authors.forename: P
authors.initials: P
authors.lastname: Sartorato
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood*; D001794:Blood Pressure / Q000187:drug effects; D002191:Canrenoic Acid / Q000009:adverse effects* / Q000627:therapeutic use*; D004573:Electrolytes / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use*; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D004573:Electrolytes; D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone; D002191:Canrenoic Acid; D012083:Renin