scholarly journals Eplerenone as a treatment for resistant hypertension in pregnancy

2019 ◽  
pp. 1753495X1982596
Author(s):  
Jessica Gehlert ◽  
Adam Morton
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Resistant Hypertension ◽  
Mineralocorticoid Receptor ◽  
Sleep Apnoea ◽  
Primary Hyperaldosteronism ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Mineralocorticoid Receptor Antagonist ◽  
Obstructive Sleep ◽  
In Pregnancy

Mineralocorticoid receptor antagonists are highly effective in the management of resistant hypertension and primary hyperaldosteronism. Recent studies demonstrate that mineralocorticoid receptor antagonists significantly reduce blood pressure, severity of obstructive sleep apnoea and arterial stiffness in patients with resistant hypertension and moderate–severe obstructive sleep apnoea. Eplerenone is a selective mineralocorticoid receptor antagonist that does not act as an androgen receptor blocker, thus reducing the risk of fetal anti-androgenic effects. Rat and rabbit studies demonstrated that when exposed to 30 times the equivalent therapeutic human dose, 100 mg/day, there were no teratogenic or demasculinisation effects. To date, the use of eplerenone has been reported in six human pregnancies in women with Gitelman syndrome, primary hyperaldosteronism and cardiac failure, in which no teratogenic effects were seen. Described here is a case of resistant hypertension associated with obstructive sleep apnoea in pregnancy, treated with eplerenone. The potential role of using eplerenone in pregnancy as treatment for resistant hypertension is discussed. Trial registration: Not applicable.

Obstructive Sleep Apnoea in Pregnancy

2007 ◽  
Vol 2 (4) ◽  
pp. 122-125
Author(s):  
Suryakant LNU ◽  
Sanjay Kumar Verma
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep ◽  
In Pregnancy

scholarly journals Effectiveness of a 12-week physical exercise programme on blood pressure in adults with true resistant hypertension and high risk of obstructive sleep apnoea: a study protocol for a pre-post test non randomised clinical trial

2020 ◽  
Vol 7 (2) ◽  
pp. 112
Author(s):  
Suranga Dassanayake ◽  
Gerard Wilkins ◽  
Gisela Sole ◽  
Margot Skinner
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
High Risk ◽  
Obstructive Sleep Apnoea ◽  
Resistant Hypertension ◽  
Randomised Clinical Trial ◽  
Exercise Programme ◽  
Primary Outcome Measure ◽  
Sleep Apnoea ◽  
Obstructive Sleep

<p class="abstract"><strong>Background:</strong> Resistant hypertension, a special phenotype of hypertension, is associated with increased cardiovascular risk. Exercise and physical activity are recommended as non-pharmacological interventions to manage blood pressure in hypertension. Little is known about the effectiveness of exercise in resistant hypertension. A bidirectional relationship has been identified between resistant hypertension and obstructive sleep apnoea but the literature pertaining to the benefit of exercise for populations with both conditions, is minimal. This study aims to identify the effectiveness of exercise in reducing blood pressure in a cohort of adults with resistant hypertension and high risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Methods:</strong> Dunedin based adults with resistant hypertension and high risk of obstructive sleep apnoea will be recruited from the community and health centres to participate in the study. Consenting volunteers (no. of fourteen) will participate in a 12-week exercise programme including aerobic and strength training. The primary outcome measure will be 24h ambulatory blood pressure while the secondary outcomes will be anthropometrics, activity parameters, sleep parameters, cardiac structure and function, and quality of life. The measurements at the end of the 12-week exercise programme will be compared with baseline to determine the effectiveness of exercise in reducing blood pressure in the cohort with resistant hypertension and risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Conclusions: </strong>Exercise and physical activity are recommended to manage hypertension. Therefore, it is anticipated that the exercise programme will have a positive effect on the blood pressure of the participants. The findings have potential to change the direction of research in the area by filling the knowledge gaps.</p><p class="abstract"><strong>Trial Registration:</strong> The Ministry of Health, New Zealand (Ethics Ref: 18/CEN/257), Trial registry: ACTRN12618001881224p).</p>

scholarly journals New clinical opportunities for mineralocorticoid receptor antagonists: focus on antifibrotic effects

2021 ◽  
Vol 93 (9) ◽  
pp. 1132-1137
Author(s):  
Natalia A. Dragomiretskaya ◽  
Aida I. Tarzimanova ◽  
Julia S. Kucherova ◽  
Valery I. Podzolkov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Mineralocorticoid Receptor ◽  
Primary Hyperaldosteronism ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Antiproliferative Effects ◽  
New Information ◽  
Coronavirus Infection

Mineralocorticoid receptor antagonists have been successfully used for many years to treat patients with primary hyperaldosteronism, refractory arterial hypertension and chronic heart failure. The increased interest in this drug in recent years is due to new information about its antifibrotic and antiproliferative effects, both cardiac and extracardiac. The article also discusses the possibility of using spironolactone in patients with the new coronavirus infection SARS-CoV-2 (COVID-19).

Mineralocorticoid Receptor Antagonists in Primary Aldosteronism

2019 ◽  
Vol 24 (46) ◽  
pp. 5508-5516 ◽  
Author(s):  
Konstantinos Stavropoulos ◽  
Christodoulos Papadopoulos ◽  
Konstantinos Koutsampasopoulos ◽  
Georgios Lales ◽  
Christos Mitas ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Mineralocorticoid Receptor ◽  
Target Organ Damage ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Clinical Syndrome ◽  
Mineralocorticoid Receptor Antagonists ◽  
Receptor Antagonists ◽  
Mineralocorticoid Receptor Antagonist

Background:Primary aldosteronism is the most common causes of secondary hypertension. Patients suffering from this clinical syndrome have an increased cardiovascular risk and target organ damage. Mineralocorticoid receptor antagonists are the optimal pharmaceutical option for the management of such patients.Objectives:The study aimed to assess the effects of mineralocorticoid receptor antagonist in the treatment of patients with primary aldosteronism.Method:We conducted an in-depth review of the literature and comprehensive identification of the clinical studies investigating the efficacy of mineralocorticoid receptor antagonists in individuals with primary aldosteronism.Results:Mineralocorticoid receptor antagonists result in significant improvement in blood pressure and serum potassium level among patients with primary aldosteronism. Moreover, mineralocorticoid receptor antagonists reverse left ventricular hypertrophy, albuminuria, and carotid intima-media thickness. However, a high risk for atrial fibrillation remains among subject with primary aldosteronism in such agents.Conclusion:Mineralocorticoid receptor antagonists are recommended as the first-line treatment in patients with bilateral primary aldosteronism. In patients with unilateral aldosterone-producing adenoma, adrenalectomy should be preferred. However, existing data presents significant limitations and is rather inconclusive. Future randomized control trials are required in order to illustrate the field.

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