title: Suppression of primary aldosteronism and resistant hypertension by the peroxisome proliferator-activated receptor gamma agonist pioglitazone.
abstract: The peroxisome proliferator-activated receptor gamma (PPAR γ) agonists have been reported to have antiproliferative and tumor-suppressive effects. We report a case of 55-year-old man with primary aldosteronism (PA) whose hyperaldosteronism was suppressed with the PPAR γ agonist pioglitazone. He had drug-resistant hypertension, hypokalemia, and diabetes mellitus. The diagnosis of PA was confirmed by the oral sodium loading test (20.5 μg/d of urinary aldosterone) and Captopril challenge test (19.5 ng/dL of plasma aldosterone). Computed tomography imaging revealed no apparent adrenal mass. The result of the posture stimulation test was consistent with the diagnosis of idiopathic adrenal hyperplasia. On administration of pioglitazone (30 mg/d) and nifedipine (40 mg/d), hypertension and hypokalemia improved and plasma aldosterone decreased for more than 6 months. The sodium loading test done after 6 months of the administration revealed the near normal results (11.2 ng/dL of plasma aldosterone and 13.1 μg/d of urinary aldosterone). The findings indicated that pioglitazone suppressed PA.
authors: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
authors: Yusuke
authors: Y
authors: Kashiwagi
authors: Yuji
authors: Y
authors: Mizuno
authors: Eisaku
authors: E
authors: Harada
authors: Makoto
authors: M
authors: Shono
authors: Sumio
authors: S
authors: Morita
authors: Michihiro
authors: M
authors: Yoshimura
authors: Mayumi
authors: M
authors: Yano
authors: Hirofumi
authors: H
authors: Yasue
mesh_terms: D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015897:Comorbidity; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D047495:PPAR gamma / Q000819:agonists*; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D047495:PPAR gamma; D045162:Thiazolidinediones; D000450:Aldosterone; D000077205:Pioglitazone