title: Espironolactone improves flow-mediated vasodilatation in subjects with the metabolic syndrome.
abstract: BACKGROUND
  The role of aldosterone in the pathophysiology of the metabolic syndrome (MS)-related endothelial dysfunction has been the subject of recent research.
  
  
  OBJECTIVE
  To evaluate the effects of aldosterone blockade on flow-mediated vasodilation (FMD) and on renal and metabolic parameters of patients with the MS.
  
  
  METHODS
  19 MS subjects underwent clinical examination, laboratory work-up (serum lipid profile, glucose and insulin; creatinine clearance; microalbuminuria investigation), ambulatory blood pressure monitoring (ABPM), and FMD analysis before and after 16 weeks of aldosterone blockade with spironolactone.
  
  
  RESULTS
  After the treatment period, FMD increased from 7.6 ± 5.63% to 15.0 ± 6.10% (p < 0.001), associated with a non-significant decrease of blood pressure (from 142.2 ± 16.37 mmHg to 138.8 ± 16.67 mmHg, and from 84.3 ± 10.91 mmHg to 82.7 ± 9.90 mmHg, respectively). HDL-cholesterol significantly increased, microalbuminuria showed a decreasing trend and creatinine clearance did not change after treatment.
  
  
  CONCLUSIONS
  Aldosterone blockade in patients with the MS improved FMD without interfering with metabolic and renal parameters.
authors.affiliation: Universidade Federal de Juiz de Fora, Brazil. jclovisi@cardiol.br
authors.forename: Julio Cesar Moraes
authors.initials: JC
authors.lastname: Lovisi
authors.forename: Daniele Andrade Guedes
authors.initials: DA
authors.lastname: Ezequiel
authors.forename: Monica Barros
authors.initials: MB
authors.lastname: Costa
authors.forename: Thaís Chehuen
authors.initials: TC
authors.lastname: Bicalho
authors.forename: Fernanda Castro
authors.initials: FC
authors.lastname: Barros
authors.forename: Gustavo do Carmo E
authors.initials: Gdo C
authors.lastname: Souza
authors.forename: Rogério Baumgratz de
authors.initials: RB
authors.lastname: Paula
mesh_terms: D000293:Adolescent; D000328:Adult; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D011446:Prospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D014664:Vasodilation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone