<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662017000600797</article-id>
<article-id pub-id-type="doi">10.24245/mim.v33i6.1452</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Papel de la espironolactona en el tratamiento de la hipertensión arterial resistente]]></article-title>
<article-title xml:lang="en"><![CDATA[Role of spironolactone in the treatment of resistant hypertension.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solache-Ortiz]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alcocer Díaz-Barreiro]]></surname>
<given-names><![CDATA[L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cadena-Loces]]></surname>
<given-names><![CDATA[MG.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Uribe-Miranda]]></surname>
<given-names><![CDATA[AV.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldrete-Velasco]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez-García]]></surname>
<given-names><![CDATA[JA.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de San Juan del Río  ]]></institution>
<addr-line><![CDATA[San Juan del Río Querétaro]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano de Salud Cardiovascular  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Cardiometabólica de San Juan del Río  ]]></institution>
<addr-line><![CDATA[ Querétaro]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital General de San Juan del Río  ]]></institution>
<addr-line><![CDATA[San Juan del Río Querétaro]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Paracelsus, SA de CV  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital General de Ciudad Victoria  ]]></institution>
<addr-line><![CDATA[Tamaulipas ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>33</volume>
<numero>6</numero>
<fpage>797</fpage>
<lpage>808</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662017000600797&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662017000600797&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662017000600797&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Este artículo aporta herramientas útiles para el diagnóstico y el diagnóstico diferencial de la hipertensión arterial resistente. En él, se refieren las recomendaciones de las principales guías internacionales de tratamiento respecto de las cifras meta de presión arterial, la incapacidad o falla del tratamiento triple en un amplio porcentaje de pacientes y los factores para la elección racional del cuarto agente para la institución de un tratamiento cuádruple. Esta elección se basa en la capacidad de la espironolactona -antagonista de los receptores de aldosterona- para inhibir los efectos nocivos de la aldosterona que dificultan el control de la presión arterial e incrementan el riesgo cardiovascular en un alto porcentaje de pacientes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This article provides useful tools for the diagnosis and differential diagnosis of resistant hypertension. Here, we refer the recommendations of the main international guidelines of management respect to the target goals of the blood pressure, the failure of triple therapy in a large percentage of patients and the factors for the rational choice of the fourth agent for the institution of a quadruple therapy. This choice is based on the ability of spironolactone, antagonist of aldosterone receptors, to inhibit the deleterious effects of aldosterone that difficult the control of blood pressure and increase the cardiovascular risk in a high percentage of patients.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[aldosterona]]></kwd>
<kwd lng="es"><![CDATA[antagonistas de la aldosterona]]></kwd>
<kwd lng="es"><![CDATA[espironolactona]]></kwd>
<kwd lng="es"><![CDATA[hipertensión arterial resistente]]></kwd>
<kwd lng="es"><![CDATA[monitoreo ambulatorio de la presión arterial de 24 horas]]></kwd>
<kwd lng="en"><![CDATA[aldosterone]]></kwd>
<kwd lng="en"><![CDATA[aldosterone antagonists]]></kwd>
<kwd lng="en"><![CDATA[spironolactone]]></kwd>
<kwd lng="en"><![CDATA[resistant hypertension]]></kwd>
<kwd lng="en"><![CDATA[ambulatory 24-hour blood pressure monitoring]]></kwd>
</kwd-group>
</article-meta>
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