Biomedical papers, 2013 (vol. 157), issue 1

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013, 157(1):50-55 | 10.5507/bp.2012.078

The effect of spironolactone in patients with resistant arterial hypertension in relation to baseline blood pressure and secondary causes of hypertension

Jan Vaclavika, Richard Sedlakb, Jiri Jarkovskyc, Eva Kocianovaa, Milos Taborskya
a Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
b Department of Internal Medicine, Prostejov Hospital, Prostejov
c Institute of Biostatistics and Analyses, Faculty of Medicine and Faculty of Science, Masaryk University, Brno

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.

Keywords: resistant hypertension, spironolactone, clinical trials, blood pressure, secondary hypertension

Received: February 10, 2012; Prepublished online: October 31, 2012; Published: March 1, 2013


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