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Effect of spironola...
Effect of spironolactone on blood pressure in subjects with resistant hypertension
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Chapman, N. (author)
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Dobson, J. (author)
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Wilson, S. (author)
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- Dahlöf, Björn, 1953 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Sever, P. S. (author)
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Wedel, H. (author)
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Poulter, N. R. (author)
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(creator_code:org_t)
- 2007
- 2007
- English.
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In: Hypertension. - 1524-4563. ; 49:4, s. 839-45
- Related links:
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https://gup.ub.gu.se...
Abstract
Subject headings
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- Spironolactone is recommended as fourth-line therapy for essential hypertension despite few supporting data for this indication. We evaluated the effect among 1411 participants in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm who received spironolactone mainly as a fourth-line antihypertensive agent for uncontrolled blood pressure and who had valid BP measurements before and during spironolactone treatment. Among those who received spironolactone, the mean age was 63 years (SD: +/-8 years), 77% were men, and 40% had diabetes. Spironolactone was initiated a median of 3.2 years (interquartile range: 2.0 to 4.4 years) after randomization and added to a mean of 2.9 (SD: +/-0.9) other antihypertensive drugs. The median duration of spironolactone treatment was 1.3 years (interquartile range: 0.6 to 2.6 years). The median dose of spironolactone was 25 mg (interquartile range: 25 to 50 mg) at both the start and end of the observation period. During spironolactone therapy, mean blood pressure fell from 156.9/85.3 mm Hg (SD: +/-18.0/11.5 mm Hg) by 21.9/9.5 mm Hg (95% CI: 20.8 to 23.0/9.0 to 10.1 mm Hg; P<0.001); the BP reduction was largely unaffected by age, sex, smoking, and diabetic status. Spironolactone was generally well tolerated; 6% of participants discontinued the drug because of adverse effects. The most frequent adverse events were gynecomastia or breast discomfort and biochemical abnormalities (principally hyperkaliemia), which were recorded as adverse events in 6% and 2% of participants, respectively. In conclusion, spironolactone effectively lowers blood pressure in patients with hypertension uncontrolled by a mean of approximately 3 other drugs. Although nonrandomized and not placebo controlled, these data support the use of spironolactone in uncontrolled hypertension.
Keyword
- Aged
- Aldosterone Antagonists/adverse effects/*therapeutic use
- Antihypertensive Agents/therapeutic use
- Blood Pressure/*drug effects
- Breast/drug effects
- Drug Resistance
- Female
- Gynecomastia/chemically induced
- Humans
- Hyperkalemia/chemically induced
- Hypertension/*drug therapy
- Male
- Middle Aged
- Pain/chemically induced
- Retreatment
- Spironolactone/adverse effects/*therapeutic use
- Treatment Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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