000			02440na a2200265 4500
003			PC6975
005			20180417112621.0
008			130622s2011 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_aGarcía Donaire, José Antonio _91624 _eNefrología
100			_aPraga Terente, Manuel _91488 _eNefrología
100			_9539 _aRuilope Urioste, Luis Miguel _eNefrología
100			_aSegura de la Morena, Julián _91486 _eNefrología
245	0	0	_aValidation of a therapeutic scheme for the treatment of resistant hypertension _h[artículo]
260			_c2011. _bJournal of the American Society of Hypertension,
300			_a5(6):498-504.
500			_aFormato Vancouver: Segura J, Cerezo C, Garcia-Donaire JA, Schmieder RE, Praga M, de la Sierra A, et al. Validation of a therapeutic scheme for the treatment of resistant hypertension. J Am Soc Hypertens. 2011;5(6):498-504.
501			_aPMID: 21963042
504			_aContiene 32 referencias.
520			_aWe tested the hypothesis that a therapeutic strategy of substituting the diuretic (most commonly hydrochlorothiazide) with chlorthalidone (50 mg/day), and, if needed, the calcium channel blocker with the highest dose of the most commonly used calcium antagonist (amlodipine 10 mg), and adding on top a direct renin inhibitor (aliskiren 300 mg) is effective to treat resistant hypertensive patients not responding to spironolactone. The scheme was tested in a group of 76 patients who had true treatment resistant hypertension (24-hour mean blood pressure ≥130/80 mm Hg while receiving three or more drugs). An effective response to spironolactone was defined as 24-hour ambulatory systolic blood pressure (SBP) drop by more than 20 mm Hg, and was obtained with 25-50 mg in 60 patients (78.9%). In patients with inadequate response to spironolactone (n = 16), we administered the triple combination plus the remaining therapy, a mean decrease of 29 mm Hg (95% CI 11-48; P = .004) for SBP and 12 mm Hg (95% CI: 4-20 mm Hg) for diastolic BP were observed. In only 1 of 16 patients (6%), the response was considered as insufficient. These data indicate the need for further testing this scheme that looks really promising to treat resistant hypertensive patients not responding to spironolactone.
710			_986 _aServicio de Nefrología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/6/pc6975.pdf _ySolicitar documento
942			_2ddc _cART _n0
999			_c6975 _d6975