The Contrast Study Of Aldosterone Escape In Patients With Essential Hypertension After Acei Or Arb Treatment

Objective:to observe whether RAS inhibitors therapy include aldsterone escape in patients with essential hypertension and difference of the escape.Methods:One hundred and twenty-four patients with essential hypertension were randomly to receive valsartan(80mg/d,n=61) and benazepril(10mg/d,n=62).The blood pressure,plasma PRA,Ang Ⅱ,Ald levels were determined before therapy and one month,three months,six months after the treatment.Results:The both levels of blood pressure decreased significantly with no defference was found between them (P>0.05).(2) In benazepril group, the plasma PRA was not significantly different (P>0.05) at the following times:before therapy and one month, three months, six months after therapy; After one-month therapy, there was apparently lower Ang Ⅱ level than that before treatment, with statistical significance (P<0.05). The Ang Ⅱ level increased after three-month and six-month therapy, gradually approaching to baseline level, without difference in statistics comparing to that before therapy (P>0.05);The Ald concentration notably decreased (P<0.01) after one month treatment, however increased after three months therapy, without difference from that before therapy (P>0.05) There was significantly higher level after six-month treatment than baseline level (P<0.01). Aldosterone escape was observed in24patients and the incidence was39%.(3) In valsartan group,there was no distinction (P>0.05) between the PRA of baseline and that of one-month, three-month, six-month therapy. The concentration of AngⅡ slightly escalated after one-month, three-month treatment compared with the baseline level, without statistical significance (P>0.05),but the concentration significantly increased after six month therapy than that of baseline (P<0.05); After one month treatment,the plasma Ald visibly falled compared with the baseline(P<0.05).It continued falling after three months therapy, however, it went up slightly after six months therapy, still lower than that of baseline (P<0.05)Conclusions:Aldosterone escape may occur in some patients with essential hypertension during more than three-month ACEI therapy; To some degree, There was aldosterone escape during ARB treatment, however, the extent of escape was lighter and the time of beginning to escape was later than that during ACEI therapy.