title: Ventricular repolarization before and after treatment in patients with secondary hypertension due to renal-artery stenosis and primary aldosteronism.
abstract: A prolonged QT interval is a risk factor for ischemic heart disease in hypertensive subjects. Patients with renal-artery stenosis and primary aldosteronism (PA) are at increased risk of cardiovascular events. The objective of the present study was to evaluate the QT interval in patients with renovascular hypertension (RV) and PA before and after treatment. A total of 24 patients with RV and 38 with PA were studied; 89 patients with essential hypertension (EH) served as control group. Corrected QT intervals (QTcH) were measured from a 12-lead ECG. Basal QTcH was longer in RV (429±30 ms) and PA (423±23 ms) compared with EH controls (407±18 ms; P<0.001). The prevalence of QTcH >440 ms was higher in RV (29%) and PA patients (29%) compared with EH controls (4%; P<0.001). QTcH interval was evaluated after treatment in 19 RV and 15 PA patients. QTcH was reduced after renal-artery angioplasty in RV patients (419±14 ms; P=0.02), and after spironolactone or adrenalectomy in PA (403±12 ms; P=0.01). In conclusion, QT interval was prolonged in patients with RV and PA compared with controls with EH. After angioplasty of renal-artery stenosis in RV, and treatment with spironolactone or adrenalectomy in PA, the cardiovascular risk of such patients may be reduced by concomitant blood pressure lowering and QT duration shortening.
authors.affiliation: Department of Medicine and Experimental Oncology, Hypertension Centre, S. Giovanni Battista Hospital, University of Turin, Turin, Italy. simmaule@tin.it
authors.forename: Simona
authors.initials: S
authors.lastname: Maule
authors.forename: Chiara
authors.initials: C
authors.lastname: Bertello
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.forename: Paolo
authors.initials: P
authors.lastname: Mulatero
authors.forename: Valeria
authors.initials: V
authors.lastname: Milazzo
authors.forename: Grazia
authors.initials: G
authors.lastname: Papotti
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D017130:Angioplasty; D001794:Blood Pressure / Q000187:drug effects; D004562:Electrocardiography; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D006978:Hypertension, Renovascular / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008133:Long QT Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D012032:Refractory Period, Electrophysiological / Q000502:physiology; D012078:Renal Artery Obstruction / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D012308:Risk Management; D013148:Spironolactone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone