Spironolactone reduced blood pressure similarly in resistant hypertension patients with and without secondary causes, but had significantly less effect in those with baseline diastolic BP >97 mmHg.
RCT (n=55)
Double-blind
Randomized
Yes
Does spironolactone reduce blood pressure in patients with resistant arterial hypertension regardless of baseline blood pressure and secondary causes?
Spironolactone effectively reduces blood pressure in resistant hypertension regardless of baseline systolic BP or secondary causes, though its effect is attenuated in patients with very high baseline diastolic BP.
AIMS: There are currently limited data about whether the effect of spironolactone in patients with resistant arterial hypertension depends on baseline blood pressure and the presence of a secondary cause of hypertension. METHODS: Patients with 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 with 55 patients treated with spironolactone. The degree of BP reduction after 8 weeks of spironolactone treatment did not differ significantly between the three tertiles of baseline systolic BP and patients with and without a secondary cause of hypertension. The reduction of office systolic, office diastolic BP and office pulse pressure was significantly lower in the highest tertile with baseline diastolic BP > 97 mmHg. CONCLUSIONS: Spironolactone treatment is effective to a similar extent both in patients with and without a secondary cause of hypertension and regardless of the baseline value of systolic BP. Less effect of spironolactone was found in patients with the highest baseline diastolic BP.
Václavík et al. (Fri,) conducted a rct in Resistant arterial hypertension (n=55). Spironolactone vs. Placebo was evaluated on Change in blood pressure after 8 weeks of treatment. Spironolactone reduced blood pressure similarly in resistant hypertension patients with and without secondary causes, but had significantly less effect in those with baseline diastolic BP >97 mmHg.