1101 FAVORABLE EFFECTS OF SPIRONOLACTONE ADDED TO OTHER ANTIHYPERTENSIVE AGENTS ON PLATELET FUNCTION IN ESSENTIAL HYPERTENSION

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Objectives: Aldosterone receptor antagonist, spironolactone (SP) could have anti-atherosclerotic effect with the improved fibrinolysis, but the effects of SP on platelet function remained to be elucidated. This study was designed to investigate the effects of SP on platelet function and their clinical implications in essential hypertensives (EHT). Design and Methods: Subjects were 62 EHT (M/F = 35/27, 60 ± 2 yrs) with insufficient control of blood pressure (BP) under the administration of antihypertensive agents except for SP. Before and 1 year after the additional administration of SP (25–50 mg/day), platelet fibrinogen binding (FgB) and platelet P-selectin expression (PsE) were measured under dosing of adenosine diphosphate (ADP). 24-hour BP and stiffness index “β” of common carotid artery, a marker of large arterial stiffness were also examined. Results: SP significantly decreased FgB (FgB at 0, 0.1, 1 μM of ADP: 26 ± 1, 34 ± 1, 69 ± 2 % to 22 ± 1, 29 ± 1, 59 ± 2 %) and PsE (PsE at 0, 1.0, 10 μM of ADP: 14 ± 1, 52 ± 2, 69 ± 2 % to 16 ± 1, 47 ± 2, 65 ± 2 %) as well as 24-hour BP (141 ± 2/84 ± 1 to 130 ± 2/78 ± 1 mmHg). In addition, SP decreased stiffness index “β” (12.0 ± 0.6 to 10.8 ± 0.4). The changes in FgB at 1.0 μM of ADP induced by SP significantly correlated with those in stiffness index “β” (r = 0.25, P < 0.05). Conclusions: In EHT, the addition of SP to other antihypertensive agents suppressed platelet activation and improved large arterial stiffness together with BP reduction. This favorable effect of SP on platelet function might be partly related to the reduction of large arterial stiffness in EHT.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.