Journal
PROGRESS IN CARDIOVASCULAR DISEASES
Volume 51, Issue 5, Pages 371-380Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.pcad.2008.02.004
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- Astra-Zeneca
- CV Therapeutics
- Novartis
- Abbott Laboratories
- Aventis
- Biovail
- Boehringer Ingelheim
- Bristol Myers-Squibb
- Forest Laboratories
- GlaxoSmithKline
- Merck Co
- Pfizer
- Sankyo Pharma
- Sanofi-Synthelabo
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Obstructive sleep apnea, aldosterone excess, and resistant hypertension are common comorbidities in obese patients. The mechanisms that link these conditions are not fully elucidated, but sympathetic nervous system activation, sodium retention, renin-angiotensin-aldosterone system stimulation, endothelial dysfunction, and increased production of reactive oxidative species may be contributing factors. Patients diagnosed with this triad should be treated with low-salt diet, weight-loss counseling, and continuous positive airway pressure, as well as aggressive antihypertensive therapy, usually with multiple agents, including a mineralocorticoid receptor antagonist. Patients with aldosterone-producing adenoma may require adrenalectomy. (C) 2009 Elsevier Inc. All rights reserved.
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