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Healthy Heart Reports

High Blood Pressure And Aldosterone

When a doctor finds out that a patient has high blood pressure, he usually tells the person that he has essential high blood pressure, prescribes medications to lower high blood pressure and makes no effort to find a cause, and the person takes medication for the rest of his life. In this month's issue of the Journal of Hypertension, a study from Wales in England shows that one in 10 have a potentially curable cause of high blood pressure called primary aldosteronism.

Your adrenal glands produce a hormone called aldosterone that causes your kidneys to retain salt. Salt holds water in your bloodstream to expand blood volume and raise blood pressure. So high levels of aldosterone cause high blood pressure, but restricting salt from your diet usually does not control high blood pressure. Some people with primary aldosteronism will be treated with surgery, but most can be controlled by taking low doses of drugs called spironolactone that blocks aldosterone or ACE inhibitors or ACE receptor blockers. However, spironolactone can make some men impotent.

If your blood pressure is higher than 140 over 80, ask your doctor to order blood aldosterone and renin tests. If your aldosterone to renin ration is high, you probably have primary aldosteronism and can cured by surgery or treated with spironolactone.

The response to other potassium-sparing diuretics and calcium channel blockers are modest. IHA responds better than angiotensin Ii-unresponsive APA to angiotensin converting enzyme inhibitors and this may also be true with angiotensin II receptor blockers. I Hypertens 19:353-361 (C) 2001 A review of the medical treatment of primary aldosteronism. PO Lim, WF Young, TM MacDonald. Journal of Hypertension, 2001, Vol 19, Iss 3, pp 353-361. Address: Lim PO, Univ Wales, Coll Med, Wales Heart Res Inst, Dept Cardiol, Heath Pk, Cardiff CF14 4XN, S Glam, WALES


Copyright 2001
Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.

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