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Medicina interna de México
versão impressa ISSN 0186-4866
Resumo
SOLACHE-ORTIZ, G. et al. Role of spironolactone in the treatment of resistant hypertension. Med. interna Méx. [online]. 2017, vol.33, n.6, pp.797-808. ISSN 0186-4866. https://doi.org/10.24245/mim.v33i6.1452.
This article provides useful tools for the diagnosis and differential diagnosis of resistant hypertension. Here, we refer the recommendations of the main international guidelines of management respect to the target goals of the blood pressure, the failure of triple therapy in a large percentage of patients and the factors for the rational choice of the fourth agent for the institution of a quadruple therapy. This choice is based on the ability of spironolactone, antagonist of aldosterone receptors, to inhibit the deleterious effects of aldosterone that difficult the control of blood pressure and increase the cardiovascular risk in a high percentage of patients.
Palavras-chave : aldosterone; aldosterone antagonists; spironolactone; resistant hypertension; ambulatory 24-hour blood pressure monitoring.