Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension

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dc.contributor.author Martín Lorenzo, Marta
dc.contributor.author Martínez, Paula J.
dc.contributor.author Baldán Martín, Montserrat
dc.contributor.author Santiago Hernández, Aranzazu
dc.contributor.author Segura, Julián
dc.contributor.author Ruiz Hurtado, Gema
dc.contributor.author Vivafranco, Fernando
dc.contributor.author Barderas, María G.
dc.contributor.author Ruilope Urioste, Luis Miguel
dc.contributor.author Álvarez Llamas, Gloria
dc.contributor.author Et al.
dc.date.accessioned 2019-03-18T10:56:59Z
dc.date.available 2019-03-18T10:56:59Z
dc.date.issued 2019
dc.identifier.citation Martin-Lorenzo, M., Martinez, P. J., Baldan-Martin, M., Lopez, J. A., Minguez, P., Santiago-Hernandez, A., … Alvarez-Llamas, G. (2019). Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension. Hypertension, 73(4), 794–802. https://doi.org/10.1161/HYPERTENSIONAHA.118.12242 spa
dc.identifier.issn 0194-911X
dc.identifier.issn 1524-4563
dc.identifier.uri http://hdl.handle.net/11268/7847
dc.description.abstract Resistant hypertension prevalence is progressively increasing, and prolonged exposure to suboptimal blood pressure control results in higher cardiovascular risk and end-organ damage. Among various antihypertensive agents, spironolactone seems the most effective choice to treat resistant hypertension once triple therapy including a diuretic fails. However success in blood pressure control is not guaranteed, adverse effects are not negligible, and no clinical tools are available to predict patient's response. Complementary to our previous study of resistant hypertension metabolism, here we investigated urinary proteome changes with potential capacity to predict response to spironolactone. Twenty-nine resistant hypertensives were included. A prospective study was conducted and basal urine was collected before spironolactone administration. Patients were classified in responders or nonresponders in terms of blood pressure control. Protein quantitation was performed by liquid chromatography-mass spectrometry; ELISA and target mass spectrometry analysis were performed for confirmation. Among 3310 identified proteins, HP (haptoglobin) and HPR (haptoglobin-related protein) showed the most significant variations, with increased levels in nonresponders compared with responders before drug administration (variation rate, 5.98 and 7.83, respectively). Protein-coordinated responses were also evaluated by functional enrichment analysis, finding oxidative stress, chronic inflammatory response, blood coagulation, complement activation, and regulation of focal adhesions as physiopathological mechanisms in resistant hypertension. In conclusion, protein changes able to predict patients' response to spironolactone in basal urine were here identified for the first time. These data, once further confirmed, will support clinical decisions on patients' management while contributing to optimize the rate of control of resistant hypertensives with spironolactone. spa
dc.description.sponsorship Sin financiación spa
dc.language.iso eng spa
dc.title Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension spa
dc.type article spa
dc.description.impact 7.713 JCR (2019) Q1, 4/65 Peripheral Vascular Disease spa
dc.description.impact 2.904 SJR (2019) Q1, 7/139 Internal Medicine spa
dc.description.impact No data IDR 2019 spa
dc.identifier.doi 10.1161/HYPERTENSIONAHA.118.12242
dc.rights.accessRights closedAccess spa
dc.subject.uem Cardiología spa
dc.subject.uem Hipertensión spa
dc.subject.unesco Sistema cardiovascular spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa

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