P.097 ADRENALECTOMY IS MORE EFFECTIVE THAN SPIRONOLACTONE IN REDUCING ARTERIAL STIFFNESS IN PRIMARY ALDOSTERONISM☆

B. Strauch; O. Petrak; D. Wichterle; T. Zelinka; R. Holaj; J. Dvorakova; L. Safarik; M. Kasalicky; J. Widimsky

doi:10.1016/j.artres.2007.07.031

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Volume 1, Issue 2, September 2007, Pages 75 - 75

P.097 ADRENALECTOMY IS MORE EFFECTIVE THAN SPIRONOLACTONE IN REDUCING ARTERIAL STIFFNESS IN PRIMARY ALDOSTERONISM☆

Authors

B. Strauch¹, O. Petrak¹, D. Wichterle², T. Zelinka¹, R. Holaj¹, J. Dvorakova¹, L. Safarik³, M. Kasalicky⁴, J. Widimsky¹

¹3rd Internal Cliníc, General Teaching Hospital, 1st Medical School, Prague, Czech Republic

²Clinic of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic

³Clinic of Urology, General Teaching Hospital, 1st Medical School, Prague, Prague, Czech Republic

⁴1st Clinic of Surgery, General Teaching Hospital, 1st Medical School, Prague, Czech Republic

^☆

Supported by the Grant NR/8155-5 provided by IGA of the Czech Ministry of Health.

Available Online 30 August 2007.

DOI: 10.1016/j.artres.2007.07.031 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

Objective: The study was aimed at assessment of the effects of specific treatment of primary aldosteronism (PA) on the arterial stiffness.

Design and Methods: 28 patients with confirmed PA (14 with aldosterone-producing adenoma treated by unilateral laparoscopic adrenalectomy, 14 with idiopathic hyperaldosteronism (treated with spironolactone) were investigated by Sphygmocor applanation tonometer using measurement of pulse wave velocity (PWV) and augmentation index (AI) at the time of the diagnosis and then again 1 year after the specific treatment.

Results: The mean 24h-BP levels decreased from 149 ± 18/92 ± 11mmHg to 128 ± 15/81 ± 10mmHg (p<0,01) after adrenalectomy (p<0,01), and from 155 ± 16/94 ± 12 to 140 ± 18/88 ± 8mmHg (p<0,05; n.s.). on spironolactone. The PWV significantly decreased after surgery from 9,3 ± 3 na 7,6 ± 2,1 m/s (p=0,002), also the AI decreased significantly from 25 ± 9 na 17 ± 8% p=0,006. However, no significant improvement of the arterial stiffness indices was found in the patients treated with spironolactone (PWV before 9,3 ± 1,6, after 8,9 ± 1,3 m/s, n.s.; AI 24 ± 9…25 ± 8%, n.s.). After correction for differences in 24-h BP fall stays the AI fall more significant (p<0,01) in the surgically treated than spironolactone treated patients.

Conclusions: The causal surgical treatment of PA is significantly more effective in improving arterial stiffness than conservative treatment with spironolactone, also after correction for 24-h BP difference. This could indicate a possibility, that the aldosterone receptor blockade by spironolactone doesn’t fully prevent arterial wall damage mediated by aldosterone, and that nongenomic aldosterone effects could possibly play a role in patophysiology of arterial wall damage.

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Journal: Artery Research
Volume-Issue: 1 - 2
Pages: 75 - 75
Publication Date: 2007/08/30
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2007.07.031 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - B. Strauch
AU  - O. Petrak
AU  - D. Wichterle
AU  - T. Zelinka
AU  - R. Holaj
AU  - J. Dvorakova
AU  - L. Safarik
AU  - M. Kasalicky
AU  - J. Widimsky
PY  - 2007
DA  - 2007/08/30
TI  - P.097 ADRENALECTOMY IS MORE EFFECTIVE THAN SPIRONOLACTONE IN REDUCING ARTERIAL STIFFNESS IN PRIMARY ALDOSTERONISM☆
JO  - Artery Research
SP  - 75
EP  - 75
VL  - 1
IS  - 2
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2007.07.031
DO  - 10.1016/j.artres.2007.07.031
ID  - Strauch2007
ER  -

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