Hyperinsulinemia as a determinant of microalbuminuria in essential hypertension

OBJECTIVE To analyze the relationship between insulinemia and urinary albumin excretion in a group of nonobese, young adult hypertensive patients, who had never been treated with antihypertensive drugs. PATIENTS AND METHODS Forty-nine patients who fulfilled the inclusion criteria were included. Twenty-four-hour ambulatory blood pressure monitorings, urinary albumin excretion (UAE) measurements, and an oral glucose-tolerance test measuring glucose and insulin, were performed, and left ventricular mass was measured by echocardiography. Hypertensive patients were classified as normoalbuminuric when their UAE was < 30 mg/24 h (40 patients; mean UAE 13.4 +/- 7.0 mg/24 h), and as microalbuminuric…

Uso de espironolactona o doxazosina en pacientes con hipertensión arterial refractaria

Introduccion y objetivos. Valorar el uso de espironolactona o doxazosina en el tratamiento de pacientes con hipertension refractaria (HTAR). Metodos. Estudio retrospectivo comparativo de 181 pacientes con HTAR (pacientes tratados con tres farmacos, uno de ellos diuretico, sin alcanzar el control de la presion arterial [PA]) a quienes se anadio espironolactona (88 casos) o doxazosina (93 casos). Resultados. La PA sistolica (PAS) se redujo 28 mmHg (intervalo de confianza [IC] del 95%, 24-32 mmHg; p < 0,001), y la PA diastolica (PAD), 12 mmHg (IC del 95%, 9-14 mmHg; p < 0,001) en los tratados con espironolactona, y 16 mmHg (IC del 95%, 13-20 mmHg; p < 0,001) y 7 mmHg (IC del 95%, 5-9 mmHg; p <…

24-hour ambulatory pulse pressure and left ventricular mass in essential hypertension