title: Eplerenone improves carotid intima-media thickness (IMT) in patients with primary aldosteronism.
abstract: Primary aldosteronism (PA) is associated with a higher rate of cardiovascular events than essential hypertension. Although adrenalectomy has been reported to reduce carotid intima-media thickness (IMT) in patients with PA, the effects of the selective aldosterone blocker, eplerenone, on vascular damage in these patients remains unclear. To evaluate the effects of eplerenone on vascular status in PA patients, we sequentially measured carotid IMT (using computer software to calculate an average IMT for accurate and reproducible evaluation) in 22 patients including 8 patients treated by unilateral adrenalectomy and 14 patients treated with eplerenone for 12 months. Patients who underwent adrenalectomy showed significant reductions in aldosterone concentration (from 345 ± 176 pg/mL to 67 ± 34 pg/mL; P<0.01) and IMT (from 0.67 ± 0.07 mm to 0.63 ± 0.09 mm; P<0.05) 6 months after surgery. Patients treated with eplerenone showed significant reductions in IMT from baseline (0.75 ± 0.10 mm) to 6 (0.71 ± 0.11 mm; P<0.05) and 12 (0.65 ± 0.09 mm; P<0.01) months, although plasma aldosterone level increased significantly, from 141 ± 105 pg/mL to 207 ± 98 pg/mL (P<0.05). Eplerenone treatment of patients with PA reduces blood pressure, increases serum potassium level, and improves vascular status. Carotid IMT may be a useful marker for evaluating the effectiveness of eplerenone in patients with PA.
authors.affiliation: Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Hisaya
authors.initials: H
authors.lastname: Kawate
authors.forename: Chitose
authors.initials: C
authors.lastname: Matsuzaki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Shibue
authors.forename: Keizo
authors.initials: K
authors.lastname: Ohnaka
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nomura
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Takayanagi
mesh_terms: D000315:Adrenalectomy / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015415:Biomarkers; D059168:Carotid Intima-Media Thickness; D016903:Drug Monitoring; D000077545:Eplerenone; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control; D007008:Hypokalemia / Q000209:etiology / Q000517:prevention & control; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D011188:Potassium / Q000097:blood; D015203:Reproducibility of Results; D012306:Risk; D013148:Spironolactone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D000077545:Eplerenone; D011188:Potassium