December 1, 1972Archives of Internal Medicine159 citations
The syndrome of essential hypertension and suppressed plasma renin activity. Normalization of blood pressure with spironolactone
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Structured PICO
Does spironolactone reduce blood pressure in patients with essential hypertension and suppressed renin activity?
P
Population
42 patients with essential hypertension, comprising 24 patients with suppressed renin activity and a control group of 18 patients with normal renin activity
I
Intervention
Spironolactone 400 mg/day for six weeks (with maintenance doses of 100 to 200 mg/day)
C
Comparator
Placebo
O
Outcome
Change in mean blood pressuresurrogate
Spironolactone effectively normalizes blood pressure in patients with essential hypertension and suppressed renin activity, suggesting a mineralocorticoid-driven mechanism for this specific hypertensive syndrome.
Abstract
Because amino-glutethimide, an inhibitor of steroid synthesis, lowers the blood pressure of patients with essential hypertension and suppressed renin activity, the present double-blind study was designed to assess the effect of the mineralocorticoid antagonist, spironolactone, on blood pressure in such patients. Twenty-three of 24 patients with suppressed renin activity responded to spironolactone, 400 mg/day for six weeks. Average decrease in mean blood pressure was 20 mm Hg. There was no response to placebo. A control group of 18 patients with essential hypertension and normal renin activity showed no significant change in blood pressure in response to spironolactone or placebo. Fourteen spironolactone-responsive patients were normotensive when maintained on doses of 100 to 200 mg/day. This study supports the concept that the syndrome of essential hypertension with suppressed renin activity is related to mineralocorticoid secretion.
Cite This Study
Robert M. Carey (1972) studied this question.