[Spironolactone in resistant essential hypertension]. / HTA essentielle résistante : place de la spironolactone.
Presse Med
; 48(12): 1431-1438, 2019 Dec.
Article
en Fr
| MEDLINE
| ID: mdl-31473027
ABSTRACT
Resistant hypertension is defined as uncontrolled blood pressure (BP) despite three antihypertensive agents including a diuretic (thiazide diuretic if renal function is normal or loop diuretic in case of chronic kidney disease with eGFR<30mL/min), a renin-angiotensin system blocker (ARB or ACEI) and a calcium channel blocker, at optimal doses. Resistance must be confirmed by out-of-office measurements (ambulatory blood pressure monitoring or home blood pressure monitoring) and patients should be asked about treatment compliance and excessive salt or alcohol intake. If the diagnosis of resistant hypertension is confirmed, the patient should be referred to a hypertension specialist to screen for secondary causes of hypertension as they are frequent in this context. If essential resistant hypertension is confirmed, the mineralocorticoid receptor antagonist, spironolactone, should be added (25 to 50mg daily). In the event of a contraindication to spironolactone, or if adverse effects occur, a beta-blocker, an alpha-blocker, or a centrally acting antihypertensive drug should be prescribed.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Espironolactona
/
Resistencia a Medicamentos
/
Hipertensión Esencial
/
Antihipertensivos
Tipo de estudio:
Health_technology_assessment
Límite:
Humans
Idioma:
Fr
Revista:
Presse Med
Año:
2019
Tipo del documento:
Article