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Successful blood pressure control with additive administration of eplerenone, an aldosterone receptor blocker, in a patient with bilateral renovascular hypertension treated with angioplasty.

Author(s): Ibuki C, Kawamata H, Seino Y, Mizuno K

Affiliation(s): Department of Cardiology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan. ibuki@nms.ac.jp

Publication date & source: 2010, Intern Med., 49(22):2455-9. Epub 2010 Nov 15.

Publication type: Case Reports

A 29-year-old woman with refractory hypertension who previously suffered from subarchnoid hemorrhage visited our facility. The diagnosis of renovascular hypertension due to fibromuscular dysplasia was made based on a high level of plasma renin activity (PRA) and aldosterone concentration (AC), and computed tomographic image of bilateral renal artery stenosis/obstruction. Angioplasty, which could be performed only to the left renal artery, failed to regain sufficient BP control. The addition of eplerenone, an aldosterone receptor blocker, to the conventional antihypertensive drugs successfully and safely lowered BP and preserved the renal function despite the persistence of high PRA and AC values.

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