The effect of low-dose spironolactone on resistant hypertension

Engbæk, M.; Hjerrild, Mette; Hallas, Jesper; Jacobsen, I.A.

doi:10.1016/j.jash.2010.10.001

Cited by 59 publications

(24 citation statements)

References 13 publications

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“…Potassium-sparing diuretic agents (PSDs) are also valuable in the above conditions [4][5][6][7]. However, in many instances clinicians have been reluctant to prescribe them for control of blood pressure because their effects on blood pressure and serum potassium are poorly defined.…”

Section: Introductionmentioning

confidence: 99%

Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium

Roush

Ernst

Kostis

et al. 2016

Journal of Hypertension

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Section: Introductionmentioning

confidence: 99%

Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium

Roush

Ernst

Kostis

et al. 2016

Journal of Hypertension

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“…As indicated above, much recent work has established spironolactone (or eplerenone, which has less antiandrogenic activity) as a very effective fourth drug for patients with resistant hypertension, often independent of a diagnosis of obstructive sleep apnea [72][73][74]. Spironolactone has supporting outcomes evidence from ASCOT [21], many confirmatory reports worldwide of efficacy, and in low-doses is often well-tolerated.…”

Section: Aldosterone Blockadementioning

confidence: 99%

Management of Resistant Hypertension

Elliott

2011

Curr Cardiovasc Risk Rep

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Resistant" hypertension has been variously defined, but most authors accept a definition that includes a blood pressure ≥140/90 mm Hg after prescription of a diuretic and typically two other appropriately chosen antihypertensive drugs at near-maximal doses. Patients with resistant hypertension are of great public health importance because they have a high absolute cardiovascular and renal risk, greater health care expenditures, a higher prevalence of secondary hypertension and target-organ damage, and are, by definition, more "difficult to control" than hypertensive patients who are controlled with only one or two medications. Centers that specialize in these patients report that more than 90% can be diagnosed with a specific cause of their treatment resistance, and more than 50% can be controlled in a relatively short time after an appropriate intervention. This article reviews the differential diagnosis, evaluation, and outcomes of treatment paradigms for such patients, and emphasizes the role of hypertension specialists in their management.

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“…Spironolactone is a mineralocorticoid receptor antagonist which was shown to lower blood pressure effectively in patients with resistant arterial hypertension. A number of uncontrolled trials showed the positive effect of small doses of spironolactone (25-50 mg) in lowering blood pressure in patients with resistant arterial hypertension [2][3][4][5][6][7][8][9][10][11][12] . The addition of spironolactone to other antihypertensive medications usually led to a marked decrease of systolic BP (-14 to -36 mmHg) and diastolic BP (-7 to -12.5 mmHg) (ref.…”

Section: Introductionmentioning

confidence: 99%

Effect of spironolactone in patients with resistant arterial hypertension in relation to age and sex: Insights from the aspirant trial

Václavík¹,

Sedlak²,

Jarkovský³

et al. 2014

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. There are currently limited data on whether the effect of spironolactone in patients with resistant arterial hypertension depends on age and sex. Methods. Patients with an office systolic blood pressure (BP) >140 mmHg or diastolic BP >90 mmHg, despite treatment with at least 3 antihypertensive drugs including a diuretic, were randomly assigned to receive spironolactone or a placebo for 8 weeks in a double-blind, placebo-controlled, multicentre trial (ASPIRANT). Results. Analyses were done on 55 patients treated with spironolactone and 56 patients treated with placebo. Significant reductions of office systolic BP (-8.9 ± 6.7 mmHg, P=0.012), 24-h ABPM systolic BP (-7.9 ± 7.2 mmHg, P=0.032) and ABPM day-time systolic BP (-7.5 ± 7.1 mmHg) after 8 weeks of spironolactone treatment, compared to placebo, were only observed in patients with a median age >62 years. The office and ABPM systolic BP reductions in patients aged ≤62 years and diastolic BP reductions by spironolactone in both age groups were not significant compared to placebo. Women tended to have a nonsignificantly higher reduction in systolic BP with spironolactone treatment, and there was no difference in diastolic BP reduction between women and men. Conclusions. S pironolactone only leads to a reduction of systolic BP in older patients with resistant arterial hypertension aged >62 years, and is effective to a similar extent in men and women.

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The effect of low-dose spironolactone on resistant hypertension

Cited by 59 publications

References 13 publications

Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium

Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium

Management of Resistant Hypertension

Effect of spironolactone in patients with resistant arterial hypertension in relation to age and sex: Insights from the aspirant trial

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