[Use of spironolactone and indapamide in the treatment of low-renin arterial hypertension].
OBJECTIVE
To compare efficacy of use of the blocker of aldosteron receptors spironolactone and diuretic indapamide in low-renin arterial hypertension (AH), their action on blood pressure, serum concentrations of sodium, potassium, creatinine, plasmic renin activity (PRA), plasmic aldosteron concentration (PAC).


METHODS
The study included 31 females aged 40-60 years with hardly correctable AH and high PAC to (PRA) ratio. Biochemical parameters were measured before 2-week treatment with indapamide (1.5 mg/day) and spironolactone (25 mg/day) and after the treatment. Between the courses there was a 2-week interval.


RESULTS
In AH patients with high PAC/PRA spironolacton reduced AP more significantly (-15.5 / -8.2 mmHg) than indapamide (-10.9 / -5.9 mmHg). Indapamide lowered potassium serum levels by 0.28 mmol/l (p < 0.05), spironolacton raised it by 0.26 mmol/l (p = 0.05). Sodium concentration in the serum reduced only after treatment with spironolactone. Both drugs increased blood concentrations of creatinine, aldosteron, PRA, but spironolactone was more active.


CONCLUSIONS
In treatment-resistant AH it is necessary to perform screening for detection of patients with low-renin hypertension. Such patients are effectively treated with spironolacton in low doses.
Naudzhunas
A
A
Bagdonas
G
G
Yankauskene
L
L
Kazanavichus
G
G
D000328:Adult; D000450:Aldosterone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007190:Indapamide / Q000627:therapeutic use*; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood*; D012964:Sodium / Q000097:blood; D013148:Spironolactone / Q000627:therapeutic use*; D016896:Treatment Outcome
D015415:Biomarkers; D004232:Diuretics; D013148:Spironolactone; D000450:Aldosterone; D012964:Sodium; D003404:Creatinine; D012083:Renin; D007190:Indapamide; D011188:Potassium