{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:23:09Z","timestamp":1740172989375,"version":"3.37.3"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T00:00:00Z","timestamp":1496275200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"funder":[{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["NA7313"],"award-info":[{"award-number":["NA7313"]}],"id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jtim-2017-0020_s_023_w2aab3b8c23b1b7b1aab1c16b1Aa\">\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Resistant hypertension is an important problem; nearly half of diagnosed hypertensives are not controlled to target blood pressure levels, and approximately 90% of strokes occur among patients with resistant hypertension. Primary aldosteronism accounts for approximately 20% of resistant hypertension, but the role of secondary hyperaldosteronism in resistant hypertension is seldom considered. We assessed the effects of eplerenone in patients with hypertension and either primary or secondary hyperaldosteronism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jtim-2017-0020_s_024_w2aab3b8c23b1b7b1aab1c16b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with a history of resistant hypertension and a supine plasma aldosterone level \u2265 360 pmol\/L were randomized to eplerenone versus placebo in a fully blinded study for one year. A medication intensity score was developed to assess the resistance of hypertension to medication (blood pressure \u00d7 medication intensity). We assessed the effects of eplerenone on blood pressure and on resistance to concomitant medication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jtim-2017-0020_s_025_w2aab3b8c23b1b7b1aab1c16b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Final results were available in 37 patients (19 on eplerenone and 18 on placebo). Resistance to medication, as assessed by the intensity of concomitant medication required to maintain blood pressure control, was markedly reduced by eplerenone: medication intensity scores declined by \u20130.50 \u00b1 1.04 (SD) on placebo versus \u20132.11 \u00b1 1.45 with eplerenone (<jats:italic>P<\/jats:italic> = 0.0001), the Systolic Resistance Score declined by \u201380.00 \u00b1 122.93 on placebo versus \u2013334.05 \u00b1 21.73 on eplerenone (<jats:italic>P<\/jats:italic> = 0.0001), and the Diastolic Resistance Score increased by 1.28 \u00b1 31.65 on placebo and declined by \u201340.74 \u00b1 57.08 on eplerenone (<jats:italic>P<\/jats:italic> = 0.009).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jtim-2017-0020_s_026_w2aab3b8c23b1b7b1aab1c16b4Aa\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Eplerenone significantly reduced resistance to concomitant antihypertensive medication in both primary and secondary hyperaldosteronism.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jtim-2017-0020","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T08:08:10Z","timestamp":1499069290000},"page":"93-99","source":"Crossref","is-referenced-by-count":3,"title":["Effects of eplerenone on resistance to antihypertensive medication in patients with primary or secondary hyperaldosteronism"],"prefix":"10.1515","volume":"5","author":[{"given":"J. David","family":"Spence","sequence":"first","affiliation":[{"name":"Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute , Western University , London , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysi","family":"Bogiatzi","sequence":"additional","affiliation":[{"name":"Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute , Western University , London , Canada"},{"name":"McMaster University , Hamilton , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariya","family":"Kuk","sequence":"additional","affiliation":[{"name":"Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute , Western University , London , Canada"},{"name":"University of Ottawa , Ottawa , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George K.","family":"Dresser","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology , Western University , London , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel G.","family":"Hackam","sequence":"additional","affiliation":[{"name":"Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute , Western University , London , Canada"},{"name":"Division of Clinical Pharmacology , Western University , London , Canada"},{"name":"Department of Epidemiology & Biostatistics , Western University , London , Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2017,6,30]]},"reference":[{"key":"2023042508112909293_j_jtim-2017-0020_ref_001_w2aab3b8c23b1b7b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Spence JD. Blood pressure control in Canada: the view from a stroke prevention clinic. Can J Cardiol 2015;31:593-5.","DOI":"10.1016\/j.cjca.2015.03.005"},{"key":"2023042508112909293_j_jtim-2017-0020_ref_002_w2aab3b8c23b1b7b1ab2b2b2Aa","doi-asserted-by":"crossref","unstructured":"Li C, Engstr\u00f6m G, Hedblad B, Berglund G, Janzon L. Blood pressure control and risk of stroke: a population-based prospective cohort study. Stroke 2005;36:725-30.","DOI":"10.1161\/01.STR.0000158925.12740.87"},{"key":"2023042508112909293_j_jtim-2017-0020_ref_003_w2aab3b8c23b1b7b1ab2b2b3Aa","doi-asserted-by":"crossref","unstructured":"Sprint RG, Wright JT, Jr., Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med 2015;373:2103-16.","DOI":"10.1056\/NEJMoa1511939"},{"key":"2023042508112909293_j_jtim-2017-0020_ref_004_w2aab3b8c23b1b7b1ab2b2b4Aa","doi-asserted-by":"crossref","unstructured":"Spence JD. 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