{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:15:42Z","timestamp":1761513342699},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6_pt_3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[1983,11]]},"abstract":"<jats:p>Spironolactone (SPL) corrects hypertension, hypokalemia, and hyporeninemia in patients with primary hyperaldosteronism (PHA) by blocking mineralocorticoid (MCH) receptors. We evaluated the effect of continuous SPL treatment (100 to 300 mg\/day for 7 days to 9 years) on plasma renin (PRC), potassium, aldosterone (PA), 18-hydroxycorticosterone (18-OHB), deoxycorticosterone (DOC), and corticosterone (B) concentrations and 24-hour urinary excretion of aldosterone (UA) in 24 patients with PHA (15 with an aldosterone-producing adenoma [APA] and nine with idiopathic PHA [IHA]). Despite the normalization of PRC and K in both APA and IHA patients by SPL, UA and PA failed to increase in APA (55.8 +\/- 8.8 to 51.4 +\/- 7.3 micrograms\/24 hr and 54.0 +\/- 9.4 to 44.6 +\/- 6.2 ng\/dl, respectively) in contrast to rises in IHA patients (22.3 +\/- 2.5 to 69.3 +\/- 10.3 micrograms\/24 hr and 16.0 +\/- 1.0 to 49.9 +\/- 9.9 ng\/dl). Similar corrections with amiloride (20-40 mg\/day for 2 months) in one patient with APA produced a three- to fourfold increase in UA and PA. In addition, while on SPL the characteristic fall or no change in PA and 18-OHB during upright posture persisted in all APA patients despite further increases in PRC (4.48 +\/- 1.15 to 7.86 +\/- 1.89) and K (4.0 +\/- 0.1 to 4.3 +\/- 0.1). The patterns of the aldosterone precursors, DOC, B, and 18-OHB, and their ratios to acute stimulation with cosyntropin were not altered by SPL. Thus, SPL treatment causes a sustained impairment of the aldosterone secretory response to normalized PRC and K, but not to ACTH stimulation, only in patients with APA.<\/jats:p>","DOI":"10.1161\/01.hyp.5.6_pt_3.v115","type":"journal-article","created":{"date-parts":[[2013,9,5]],"date-time":"2013-09-05T13:56:42Z","timestamp":1378389402000},"update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Studies of impaired aldosterone response to spironolactone-induced renin and potassium elevations in adenomatous but not hyperplastic primary aldosteronism."],"prefix":"10.1161","volume":"5","author":[{"given":"C E","family":"Kater","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E G","family":"Biglieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Schambelan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Arteaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","container-title":["Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.HYP.5.6_Pt_3.V115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T18:38:50Z","timestamp":1715539130000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.HYP.5.6_Pt_3.V115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1983,11]]},"references-count":0,"journal-issue":{"issue":"6_pt_3","published-print":{"date-parts":[[1983,11]]}},"alternative-id":["10.1161\/01.HYP.5.6_Pt_3.V115"],"URL":"https:\/\/doi.org\/10.1161\/01.hyp.5.6_pt_3.v115","relation":{},"ISSN":["0194-911X","1524-4563"],"issn-type":[{"value":"0194-911X","type":"print"},{"value":"1524-4563","type":"electronic"}],"subject":[],"published":{"date-parts":[[1983,11]]},"assertion":[{"value":"1983-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}