[Does spironolactone use at arterial hypertension therapy protect endothelium also in smoking patients?].

The aim of the study was evaluation of spironolactone effect on concentration of endothelin-1 (ET-1 - vasoconstrictive substance produced by endothelial cells) and aldosterone (Ald) and plasma renin activity (PRA) in patients with primary arterial hypertension (AH): group A--smoking patients (11 individuals) in comparison with group B--non-smoking ones (12 individuals). ET-1, Ald and PRA were assessed before treatment (examination 1) and after 20 days of spironolactone therapy in dose 25 mg/day (examination 2). We observed: In group A significant elevation of: ET-1 ((Me +/- S exam.1 - 45.55 +/- 12.95 vs. exam.2 - 63.41 +/- 12.71 pg/ml, p = 0,009) PRA (Me +/- S exam.1 - 1.8 +/- 0.78 vs. exam.2 - 3.0 +/- 1.41 ng/ml/h, p = 0,012). In group B: significant decrease of ET-1 (Me +/- S exam.1- 61.58 +/- 12.15 vs. exam.2 - 43.48 +/- 14.37 pg/ml, p = 0.0028) significant elevation of PRA (Me +/- S exam1 - 1.20 +/- 1,91 vs. exam2 - 2.51 +/- 1.78 ng/ ml/h, p = 0.028).In our investigation different action of spironolactone on ET-1 in the two groups was observed. In group B spironolactone decreased ET-1 but in group A we noticed elevated ET-1 concentration. These results indicate advantageous endothelial effect of spironolactone only in non-smoking patients with AH.