title: [Spironolactone reduces blood pressure and albuminuria of obese hypertensive patients with metabolic syndrome].
abstract: BACKGROUND
  In recent years, a role for aldosterone in pathophysiology of metabolic syndrome and hypertension in this syndrome has been suggested. However, the treatment with antagonists of mineralocorticoid receptor in these individuals has not properly addressed.
  
  
  OBJECTIVE
  To evaluate the effects of mineralocorticoid receptor blockade on blood pressure, inflammatory, metabolic and renal parameters in non-diabetic hypertensive individuals with the metabolic syndrome.
  
  
  METHODS
  Twenty nine patients with metabolic syndrome were enrolled in a prospective protocol that consisted of 2 periods: baseline (2 weeks) in which demographic data were obtained and antihypertensive medicines were withdrawn, and treatment period when the individuals were treated with spironolactone 25-50 mg once-a-day, for 16 weeks. In both periods, inflammatory, metabolic and renal parameters were assessed and the 24-hour ambulatory blood pressure monitorization was performed.
  
  
  RESULTS
  After spironolactone treatment, 24 hour systolic and diastolic blood pressure decreased from 143.5 ± 15.17 mmHg to 133.2 ± 17.34 mmHg (p = 0.025) and from 85.2 ± 11.10 mmHg to 79.3 ± 11.78 mmHg (p = 0.026), respectively. HDL-cholesterol increased from 44.0 ± 8.67 mg/dl to 49.0 ± 6.75mg/dl (p = 0.000) and C-reactive protein decreased significantly from 6.3 ± 7.54 mg/l to 4.6 ± 6.3 mg/l (p = 0.009). Fasting plasma glucose, insulin, HOMA-IR and triglycerides did not change significantly after mineralocorticoid receptor blockade. Estimated glomerular filtration rate did not change whereas the logarithm of albuminuria decreased significantly from 2.5 ± 0.92 to 2.0 ± 0.9 (p = 0.028).
  
  
  CONCLUSIONS
  In hypertensive subjects with MS the administration of spironolactone in monotherapy was effective for hypertension control, decreased urinary albumin excretion and increased HDL-cholester ol plasma.
authors.affiliation: Universidade Federal de Juiz de Fora. daniezequiel@hotmail.com
authors.forename: Danielle Guedes Andrade
authors.initials: DG
authors.lastname: Ezequiel
authors.forename: Rogerio Baumgratz de
authors.initials: RB
authors.lastname: Paula
authors.forename: Júlio César Moraes
authors.initials: JC
authors.lastname: Lovisi
authors.forename: Thaís Chehuen
authors.initials: TC
authors.lastname: Bicalho
authors.forename: Sergio Franca de
authors.initials: SF
authors.lastname: Souza Fillho
authors.forename: Sarah de Paula Iennaco de
authors.initials: Sde P
authors.lastname: Rezende
authors.forename: Monica Barros
authors.initials: MB
authors.lastname: Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D011446:Prospective Studies; D013148:Spironolactone / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone