Tom 14, Nr 5 (2017)
Nadciśnienie tętnicze
Opublikowany online: 2018-03-06
Wyświetlenia strony
510
Wyświetlenia/pobrania artykułu
717
Terapia nadciśnienia tętniczego i chorób współtowarzyszących w 2018 roku — coraz mocniejsza pozycja spironolaktonu
Choroby Serca i Naczyń 2017;14(5):233-237.
Streszczenie
W opublikowanym w 2015 roku badaniu PATHWAY-2 wykazano, że spironolakton jest najskuteczniejszym lekiem czwartego rzutu w terapii chorych z nadciśnieniem opornym. W latach 2016–2017 ukazały się kolejne publikacje potwierdzające przydatność spironolaktonu w leczeniu nadciśnienia tętniczego oraz chorób współistniejących. Celem niniejszego opracowania jest przybliżenie wyników tych badań w kontekście zarówno zaleceń nadciśnieniowych, jak i codziennej praktyki klinicznej.
Słowa kluczowe: oporne nadciśnienie tętniczespironolaktonantagoniści aldosteronurandomizowane badania kliniczne
Referencje
- Tykarski A, Narkiewicz K, Gaciong Z. Zasady postępowania w nadciśnieniu tętniczym — 2015 rok. Wytyczne Polskiego Towarzystwa Nadciśnienia Tętniczego. Nadciśnienie Tętnicze w Praktyce. 2015; 1(1): 1–70.
- Williams B, MacDonald TM, Morant S, et al. British Hypertension Society's PATHWAY Studies Group. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomised, double-blind, crossover trial. Lancet. 2015; 386(10008): 2059–2068.
- Václavík J, Sedlák R, Jarkovský J, et al. Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension. 2011; 57(6): 1069–1075.
- Liu G, Zheng XX, Xu YL, et al. Effect of aldosterone antagonists on blood pressure in patients with resistant hypertension: a meta-analysis. J Hum Hypertens. 2015; 29(3): 159–166.
- Chapman N, Dobson J, Wilson S, et al. Anglo-Scandinavian Cardiac Outcomes Trial Investigators. Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension. 2007; 49(4): 839–845.
- Wright JT, Williamson JD, Whelton PK, et al. SPRINT Research Group. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015; 373(22): 2103–2116.
- Narkiewicz K. Terapia opornego nadciśnienia tętniczego — badanie PATHWAY 2, czyli spironolakton kontratakuje. Choroby Serca i Naczyń. 2015; 12(6): 341–346.
- Liu L, Xu B, Ju Y. Addition of spironolactone in patients with resistant hypertension: a meta-analysis of randomized controlled trials. Clin Exp Hypertens. 2017; 39(3): 257–263.
- Sinnott SJ, Tomlinson LA, Root AA, et al. Comparative effectiveness of fourth-line anti-hypertensive agents in resistant hypertension: A systematic review and meta-analysis. Eur J Prev Cardiol. 2017; 24(3): 228–238.
- Doménech M, Sastre E, Camafort M, et al. Misdiagnosis of resistant hypertension: real frequency of true resistant hypertension in patients with suspected resistance to treatment. Med Clin (Barc). 2017 [Epub ahead of print].
- Yang L, Zhang H, Cai M, et al. Effect of spironolactone on patients with resistant hypertension and obstructive sleep apnea. Clin Exp Hypertens. 2016; 38(5): 464–468.
- Rosa J, Zelinka T, Petrák O, et al. Should all patients with resistant hypertension receive spironolactone? Curr Hypertens Rep. 2016; 18(11): 81.
- Parthasarathy HK, Ménard J, White WB, et al. A double-blind, randomized study comparing the antihypertensive effect of eplerenone and spironolactone in patients with hypertension and evidence of primary aldosteronism. J Hypertens. 2011; 29(5): 980–990.
- Hwang AY, Dave C, Smith SM. Trends in antihypertensive medication use among US patients with resistant hypertension, 2008 to 2014. Hypertension. 2016; 68(6): 1349–1354.
- Dudenbostel T, Calhoun DA. Use of aldosterone antagonists for treatment of uncontrolled resistant hypertension. Am J Hypertens. 2017; 30(2): 103–109.
- Ghazi L, Dudenbostel T, Lin CP, et al. Urinary sodium excretion predicts blood pressure response to spironolactone in patients with resistant hypertension independent of aldosterone status. J Hypertens. 2016; 34(5): 1005–1010.
- Pitt B, Pfeffer MA, Assmann SF, et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014; 370(15): 1383–1392.
- Pfeffer MA, Claggett B, Assmann SF, et al. Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation. 2015; 131(1): 34–42.
- Kosmala W, Rojek A, Przewlocka-Kosmala M, et al. Effect of aldosterone antagonism on exercise tolerance in heart failure with preserved ejection fraction. J Am Coll Cardiol. 2016; 68(17): 1823–1834.
- Neefs J, van den Berg NWE, Limpens J, et al. Aldosterone pathway blockade to prevent atrial fibrillation: a systematic review and meta-analysis. Int J Cardiol. 2017; 231: 155–161.
- Vukadinović D, Lavall D, Vukadinović AN, et al. True rate of mineralocorticoid receptor antagonists-related hyperkalemia in placebo-controlled trials: A meta-analysis. Am Heart J. 2017; 188: 99–108.
- Polyzos SA, Kountouras J, Mantzoros CS, et al. Effects of combined low-dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non-invasive indices of steatosis and fibrosis, and adipokine levels in non-alcoholic fatty liver disease: a randomized controlled trial. Diabetes Obes Metab. 2017; 19(12): 1805–1809.
- Chuang YW, Yu MC, Huang ST, et al. Spironolactone and the risk of urinary tract cancer in patients with hypertension: a nationwide population-based retrospective case-control study. J Hypertens. 2017; 35(1): 170–177.
- Mackenzie IS, Morant SV, Wei Li, et al. Spironolactone use and risk of incident cancers: a retrospective, matched cohort study. Br J Clin Pharmacol. 2017; 83(3): 653–663.
- Whelton P, Carey R, Aronow W, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary. J Am Coll Cardiol. 2017.
