Key result
Add-on aldosterone-receptor antagonists linked to ~22 mmHg SBP reduction in difficult-to-treat hypertension.
Why the study?
Does add-on aldosterone-receptor antagonist therapy reduce blood pressure in patients with difficult-to-treat hypertension?
Observational (n=123)
Yes
Does add-on aldosterone-receptor antagonist therapy reduce blood pressure in patients with difficult-to-treat hypertension?
Mean Difference: -22
p-value: p=<0.001
Add-on aldosterone-receptor antagonist therapy provides profound and sustained long-term blood pressure reduction in patients with difficult-to-treat hypertension.
May support aldosterone-receptor antagonist add-on in difficult-to-treat hypertension; leaves open randomized confirmation of net benefit.
Background . The long-term efficacy of aldosterone-receptor antagonists (ARAs) as add-on treatment in uncontrolled hypertension has not yet been reported. Methods . Data from 123 patients (21 with primary aldosteronism, 102 with essential hypertension) with difficult-to-treat hypertension who received an ARA between May 2005 and September 2009 were analyzed retrospectively for their blood pressure (BP) and biochemical response at first followup after start with ARA and the last follow-up available. Results . Systolic BP decreased by22±20and diastolic BP by9.4±12 mmHg after a median treatment duration of 25 months. In patients that received treatment >5 years, SBP was33±20and DBP was 16 ± 13 mmHg lower than at baseline. Multivariate analysis revealed that baseline BP and follow-up duration were positively correlated with BP response. Conclusion . Add-on ARA treatment in difficult-to-treat hypertension results in a profound and sustained BP reduction.
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Jansen et al. (2011) conducted an observational in Uncontrolled (difficult-to-treat) hypertension (n=123). Aldosterone-receptor antagonists (spironolactone or eplerenone) vs. Baseline (pre-treatment) was evaluated on Change in systolic blood pressure from baseline (MD -22 mmHg, p=<0.001). Add-on aldosterone-receptor antagonist treatment in difficult-to-treat hypertension reduced systolic blood pressure by 22 mmHg and diastolic blood pressure by 9.4 mmHg after a median of 25 months.
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