MORIMOTO Satoshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Review article
Language English
Peer review Peer reviewed
Presence of invitation Invited paper
Title Management of primary aldosteronism and mineralocorticoid receptor-associated hypertension.
Journal Formal name:Hypertension research : official journal of the Japanese Society of Hypertension
Abbreviation:Hypertens Res
ISSN code:13484214/09169636
Domestic / ForeginForegin
Volume, Issue, Page pp.744-753
Author and coauthor Morimoto Satoshi†*, Ichihara Atsuhiro
Authorship Lead author,Corresponding author
Publication date 2020/05
Summary Resistant hypertension is associated with a poor prognosis due to organ damage caused by prolonged suboptimal blood pressure control. The concomitant use of mineralocorticoid receptor (MR) antagonists with other antihypertensives has been shown to improve blood pressure control in some patients with resistant hypertension, and such patients are considered to have MR-associated hypertension. MR-associated hypertension is classified into two subtypes: one with a high plasma aldosterone level, which includes primary aldosteronism (PA), and the other with a normal aldosterone level. In patients with unilateral PA, adrenalectomy may be the first-choice procedure, while in patients with bilateral PA, MR antagonists are selected. In addition, in patients with other types of MR-associated hypertension with high aldosterone levels, MR antagonists may be selected as a first-line therapy. In patients with normal aldosterone levels, ARBs or ACE inhibitors are used as a first-line therapy, and MR antagonists may be used as an add-on agent. Since MR antagonist therapy may have efficacy as a first-line or add-on agent in these patients, it is important to recognize this type of hypertension. Further studies are needed to elucidate the pathogenesis and management of MR-associated hypertension in more detail to improve the clinical outcomes of patients with MR-associated hypertension.
DOI 10.1038/s41440-020-0468-3
PMID 32424201