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Spironolactone Reduces Arterial Resistant Hypertension

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What's This?

Spironolactone Reduces Arterial Resistant Hypertension

Background Information

Resistant hypertension is a clinical problem where the hypertension remains above the goal in spite of using other anti-hypertensive agents. If there is no secondary cause for hypertension, multidrug treatment regimens including 3, 4, or more number of drugs are necessary to lower the blood pressure.

Spironolactone, a mineralocorticoid receptor antagonist causes a significant reduction in the blood pressure in lower doses.

Aim of the Study

The aim of the study is to analyze the effect of low dose (25mg) spironolactone on blood pressure in the patient with resistant hypertension.

Inclusion criteria

The study included the patients who were above 18 years of age with arterial hypertension and patients with diabetes and chronic kidney disease whose blood pressure was above 130/80mmHg.

Exclusion criteria

The study excluded the patients who were diagnosed with:

  • Severe hypertension
  • Renal insufficiency
  • Pregnancy
  • Lactating
  • Porphyria
  • Secondary cause of hypertension

Procedure

The patients were randomly assigned into two groups, spironolactone group and placebo group. In the spironolactone group, the patients were given 25mg spironolactone. Placebo was given to the patients in the placebo group. The drugs were given once daily for both the groups. The blood pressure was monitored during the visits for every 4-8 weeks.

Sample size

A total of 150 subjects were analyzed. 74 subjects were assigned into spironolactone group and 76 subjects were assigned into placebo group.

Statistical analysis

SPSS 18.0.2 was used to analyze the results. The other statistical tools used were Mann–Whitney U test and Fisher exact test

Results

The results were analyzed by comparing the study values and the baseline values.

Reduction in the blood pressure after the study period

SpironoDAYTIME blood pressure after the study

Ambulatory blood pressure monitoring (ABPM) measures the blood pressure at regular intervals. The daytime systolic and diastolic blood pressure was found to be reduced after the eight week study period.

NIGHT TIME blood pressure after the study

There was an effective reduction in the night time blood pressure in the patients with resistant hypertension according to Ambulatory blood pressure monitoring after eight weeks of spironolactone study.

Conclusion

Concomitant use of spironolactone with other anti-hypertensives decreases the systolic and diastolic blood pressure in patients with resistant hypertension.

Reference

Jan Václavík, MD, PhD, et al. Effect of Spironolactone in Resistant Arterial Hypertension. Medicine (Baltimore). 2014 Dec; 93(27): e162.

Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602792/

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