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December 1, 2009Clinical Nephrology34 citations

Low-dose spironolactone, added to long-term ACE inhibitor therapy, reduces blood pressure and urinary albumin excretion in obese patients with hypertensive target organ damage

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Why the study?

Does low-dose spironolactone reduce blood pressure and urinary albumin excretion in obese patients with essential hypertension and target organ damage on chronic ACE inhibitor therapy?

Population

21 obese subjects with essential hypertension and preexistent target organ damage, mean age 57.3 +/- 7.1…

Comparison

Spironolactone 12.5 mg/d added to chronic ACE… vs Pre-treatment baseline (pre-post study design).

Design

Cohort

Follow-up

4 weeks

Key result

Low-dose spironolactone (12.5 mg/d) added to chronic ACE inhibitor therapy significantly reduced mean office blood pressure (110.6 to 105.0 mmHg, P=0.004) and urinary albumin excretion.

Authors

ABAndrew S. BombackPMP. MuskalaEBEdward Bald

Discussion

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Overview

Supports adjunctive low-dose spironolactone in obese ACEI-treated hypertensives with target organ damage; leaves open RCT confirmation of outcomes.

Structured PICO

Does low-dose spironolactone reduce blood pressure and urinary albumin excretion in obese patients with essential hypertension and target organ damage on chronic ACE inhibitor therapy?

P
Population
21 obese adults (mean age 57.3 years) with essential hypertension and preexistent target organ damage on chronic ACE inhibitor therapy, treated with spironolactone for 4 weeks.
I
Intervention
Spironolactone 12.5 mg/d added to chronic ACE inhibitor-based antihypertension regimens for 4 weeks.
C
Comparator
Pre-treatment baseline (pre-post study design).
O
Outcome
Changes in blood pressure (office, 24-h, and nocturnal), urinary albumin excretion, and potassium.surrogate

The addition of low-dose spironolactone to chronic ACE inhibitor therapy significantly reduces blood pressure and albuminuria in obese hypertensive patients with target organ damage, without significantly increasing serum potassium.

Main Result

Absolute Event Rate: 105% vs 110.6%

p-value: p=0.004

Cite This Study

Bomback et al. (2009) studied obese subjects with essential hypertension and preexistent target organ damage (n=21). Spironolactone vs. Baseline (pre-treatment) was evaluated on mean office blood pressure (mmHg) (p=0.004). Low-dose spironolactone (12.5 mg/d) added to chronic ACE inhibitor therapy significantly reduced mean office blood pressure (110.6 to 105.0 mmHg, P=0.004) and urinary albumin excretion.

synapsesocial.com/papers/6a75dfffc14fe0c47570716chttps://doi.org/10.5414/cnp72449
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