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Publications (3)10.08 Total impact

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    ABSTRACT: Screening for primary aldosteronism was historically recommended in patients with moderate to severe and/or resistant hypertension. Patients with mild hypertension and normotensive subjects were therefore excluded from the screening. However, a considerable number of normotensive individuals without hypokalaemia may have subclinical forms of primary aldosteronism. In this review, we describe evidence supporting the idea that primary aldosteronism is not only confined to patients with moderate to severe and/or resistant hypertension, but also exists in patients with mild hypertension and even in those with normotension. We discuss possible aetiologies, screening and diagnostic techniques and treatment options of the normotensive form of primary aldosteronism. The natural history, adverse effects and best treatment of this disease still remain to be resolved. The long-term follow-up studies of normotensive primary aldosteronism patients who receive neither adrenal surgery nor treatment with mineralocorticoid receptor antagonists might help to solve these problems.
    Best Practice & Research: Clinical Endocrinology & Metabolism 08/2012; 26(4):485-95. · 4.91 Impact Factor
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    ABSTRACT: Recent studies have reported a high prevalence of primary aldosteronism among patients with severe hypertension. However, the prevalence of this disease among normotensive and mildly hypertensive patients has not been determined. The aim of this study was to examine the prevalence of primary aldosteronism among prehypertensive and stage 1 hypertensive subjects. A total of 292 adult subjects with hypertension or prehypertension was screened for primary aldosteronism. Subjects with a plasma aldosterone concentration (ng per 100 ml) to plasma renin activity (ng ml(-1) h(-1)) ratio (ARR) above 20 underwent confirmatory captopril suppression testing. A total of 54 subjects (18.5%) had an ARR above 20. A captopril suppression test was performed in 17 of 54 subjects with probable primary aldosteronism. The test confirmed the diagnosis of primary aldosteronism in 11 (64.7%) of 17 patients, giving a least prevalence of 3.8% for this disease. The 11 patients with primary aldosteronism had a mean ± s.d. systolic blood pressure of 139 ± 4 mm Hg, diastolic blood pressure of 95 ± 10 mm Hg and serum potassium of 4.46 ± 0.48 mEq l(-1) at the time of screening test. The prevalence of primary aldosteronism as could be assessed in this study was at least 6.8% in prehypertensive patients, 3.3% in stage 1 hypertensive patients and 3.1% in stage 2 hypertensive patients. In conclusion, this study suggests a high prevalence of primary aldosteronism among prehypertensive and stage 1 hypertensive Japanese patients. Significant numbers of prehypertensive individuals may have subclinical forms of this disease.
    Hypertension Research 10/2010; 34(1):98-102. · 2.79 Impact Factor
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    ABSTRACT: FK 506 is a powerful new immunosuppressant that is more effective in preventing and treating allograft rejection than cyclosporine (CyA). This study was undertaken to examine the effect of FK 506 on stimulation of endothelin-1 (ET-1) mRNA and secretion of ET-1 in human endothelial cells (EC) compared with the effects of CyA. The dose of 0.1 [mu]M of CyA used in clinical practice induced expression of ET-1 mRNA and increased secretion of ET-1 in EC. The same dose of FK 506 had the same effect. A clinical dose of 0.01 [mu]M of FK 506 did not induce expression of ET-1 mRNA and did not increase the secretion of ET-1 in EC. These findings suggest that the lower incidence of complications seen with FK 506 is due in part to its use at a lower clinical dose compared with that of CyA. (C) Lippincott-Raven Publishers.
    Journal of Cardiovascular Pharmacology 22. · 2.38 Impact Factor