Document Detail


Low-dose spironolactone in the management of resistant hypertension: a surveillance study.
MedLine Citation:
PMID:  17351384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
METHODS: We have conducted an open observational study of the use of spironolactone 25-50 mg in the management of patients with resistant hypertension. This drug was recommended in 133 patients who were already receiving an angiotensin-blocking drug in addition to other therapies. RESULTS: Of these, three defaulted from follow-up and 11 could not tolerate spironolactone. We therefore have outcome data on 119 patients. The addition of spironolactone (median dose 25 mg) was associated with a mean (SD) fall in systolic blood pressure of 21.7 mmHg (24.0; P < 0.001) and diastolic blood pressure of 8.5 mmHg (14.9; P < 0.001). In two patients spironolactone had to be discontinued on account of a rise of serum potassium to above 6.0 mmol/l, whereas overall the mean increase in serum potassium was 0.3 mmol/l. CONCLUSION: With careful monitoring of plasma electrolytes, spironolactone at a low dose is an effective add-in drug in patients with hypertension resistant to a regime that includes an angiotensin-blocking agent.
Authors:
Deirdre A Lane; Sarah Shah; D Gareth Beevers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  25     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-08-07     Revised Date:  2008-03-21    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  891-4     Citation Subset:  IM    
Affiliation:
University Department of Medicine, City Hospital, Birmingham, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone Antagonists / administration & dosage*
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use*
Biological Markers / blood
Blood Pressure / drug effects
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Great Britain / epidemiology
Humans
Hypertension / drug therapy*,  physiopathology*
Male
Middle Aged
Population Surveillance
Spironolactone / administration & dosage*
Treatment Outcome
Vascular Resistance / drug effects*
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Biological Markers; 52-01-7/Spironolactone
Comments/Corrections
Comment In:
J Hypertens. 2007 Apr;25(4):747-50   [PMID:  17351364 ]
Curr Hypertens Rep. 2007 Aug;9(4):297-8   [PMID:  17686380 ]

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