Spironolactone 25 mg daily reduced office systolic blood pressure by 8.9 mmHg compared to placebo in patients with resistant arterial hypertension aged over 62 years.
RCT (n=111)
Double-blind
1:1
Yes
Does spironolactone reduce blood pressure in patients with resistant arterial hypertension depending on age and sex?
Spironolactone effectively reduces systolic blood pressure in older patients (>62 years) with resistant arterial hypertension, with similar efficacy in both men and women.
Effect estimate: MD -8.9 mmHg (95% CI -15.6; -2.1)
Absolute Event Rate: -19.6% vs -10.8%
p-value: p=0.012
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: Spironolactone 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.
Václavík et al. (Wed,) conducted a rct in Resistant arterial hypertension (n=111). Spironolactone vs. Placebo was evaluated on Change in office systolic blood pressure at 8 weeks in patients aged >62 years (MD -8.9 mmHg, 95% CI -15.6; -2.1, p=0.012). Spironolactone 25 mg daily reduced office systolic blood pressure by 8.9 mmHg compared to placebo in patients with resistant arterial hypertension aged over 62 years.