The effects of canrenone on left ventricle diastolic function, left atrial compliance and on atrial natriuretic hormones in some subjects with “challenge hypertension”.

STUDY PROPOSAL: Proposal to evaluate the response of left ventricular function of 30 patients with challenge hypertension to 50 or 100 mg of canrenone. Evaluation will be performed by repeated control of echocardiographic parameters, left atrial function and NT-proBNP. We also will use Tissue Doppler Imaging to identify and follow early left ventricular dysfunction. Careful monitoring of serum creatinine and electrolyte levels will be carried out. At the end of the study we will be able to identify the best dose of aldosterone we can recommend to control hypertension and left ventricular diastolic dysfunction. In possible successive evaluations other end points such as mortality, morbility, quality of life and hospitalization will be evaluated. Finally given the increasing knowledge of resistant hypertension and left ventricular diastolic dysfunction a prospective randomized controlled trial of canrenone would perhaps be timely.