Espironolactone improves flow-mediated vasodilatation in subjects with the metabolic syndrome.

INTRODUCTION

The role of aldosterone in the pathophysiology of the metabolic syndrome (MS)-related endothelial dysfunction has been the subject of recent research.

OBJECTIVE

To evaluate the effects of aldosterone blockade on flow-mediated vasodilation (FMD) and on renal and metabolic parameters of patients with the MS.

METHODS

19 MS subjects underwent clinical examination, laboratory work-up (serum lipid profile, glucose and insulin; creatinine clearance; microalbuminuria investigation), ambulatory blood pressure monitoring (ABPM), and FMD analysis before and after 16 weeks of aldosterone blockade with spironolactone.

RESULTS

After the treatment period, FMD increased from 7.6 ± 5.63% to 15.0 ± 6.10% (p < 0.001), associated with a non-significant decrease of blood pressure (from 142.2 ± 16.37 mmHg to 138.8 ± 16.67 mmHg, and from 84.3 ± 10.91 mmHg to 82.7 ± 9.90 mmHg, respectively). HDL-cholesterol significantly increased, microalbuminuria showed a decreasing trend and creatinine clearance did not change after treatment.

CONCLUSION

Aldosterone blockade in patients with the MS improved FMD without interfering with metabolic and renal parameters.