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首页> 外文期刊>The journal of clinical hypertension. >Aldosterone blockers (mineralocorticoid receptor antagonism) and potassium-sparing diuretics.
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Aldosterone blockers (mineralocorticoid receptor antagonism) and potassium-sparing diuretics.

机译：醛固酮阻滞剂（盐皮质激素受体拮抗作用）和保钾利尿剂。

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摘要

KEY POINTS AND PRACTICAL RECOMMENDATIONS: * Mineralocorticoid receptor (MR) antagonists (aldosterone blockers) provide effective antihypertensive treatment, especially in low-renin and salt-sensitive forms of hypertension, including resistant hypertension. * Newer, more selective MR antagonists (eg, eplerenone) have fewer of the progestational and antiandrogenic effects than spironolactone, enhancing tolerability and potentially improving adherence to therapy. * MR antagonists provide an additional benefit in the treatment of heart failure when combined with angiotensin-converting enzyme inhibitors, digoxin, and loop diuretics. * Other potassium-sparing diuretics (amiloride or triamterene) are generally prescribed for essential hypertension as a fixed-dose combination with hydrochlorothiazide. * The dose range for spironolactone with resistant hypertension is between 25 mg/d and 50 mg/d, and eplerenone is an appropriate alternative if spironolactone is not tolerated because of sexual side effects. * In general, the combined use of spironolactone and adequate doses of a thiazide diuretic or a thiazide-like agent such as chlorthalidone for the treatment of resistant hypertension maximizes efficacy and reduces the risk of spironolactone-induced hyperkalemia.
机译：要点和实用建议：*盐皮质激素受体（MR）拮抗剂（醛固酮阻滞剂）可提供有效的降压治疗，尤其是对低肾素和盐敏感型高血压，包括耐药性高血压。 *新型，选择性更高的MR拮抗剂（例如依普利农）与螺内酯相比，对孕激素和抗雄激素的作用更少，从而增强了耐受性并可能改善对治疗的依从性。 * MR拮抗剂与血管紧张素转换酶抑制剂，地高辛和combined利尿剂合用时，可在治疗心力衰竭时提供额外的好处。 *其他保钾利尿剂（阿米洛利或氨苯蝶啶）通常与氢氯噻嗪固定剂量合用，用于原发性高血压。 *抵抗性高血压的螺内酯的剂量范围在25 mg / d至50 mg / d之间，如果由于性副作用而不能耐受螺内酯，则依普利农是合适的替代药物。 *通常，螺内酯与适当剂量的噻嗪类利尿剂或类噻嗪类药物（如氯噻酮）联合使用以治疗耐药性高血压可最大程度地提高疗效，并降低螺内酯诱导的高钾血症的风险。

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