| Spironolactone management of resistant hypertension. | |
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MedLine Citation:
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PMID: 20978214 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To review the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and adverse effects of spironolactone in the treatment of resistant hypertension. DATA SOURCES: A literature search was conducted using MEDLINE (1966-July 2010), International Pharmaceutical Abstracts (1970-July 2010), and Cochrane database (2009) for the key words spironolactone or resistant hypertension. References cited in the articles were reviewed for additional information. STUDY SELECTION AND DATA EXTRACTION: English-language literature reporting pharmacology data from animal studies and clinical trials evaluating the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and adverse effects of spironolactone were included. DATA SYNTHESIS: Spironolactone is a potassium-sparing diuretic with anti-aldosterone effects that are beneficial in the management of hypertension. Spironolactone has shown improvement in 5 prospective studies and 1 retrospective study evaluating its blood pressuring-lowering abilities in patients with resistant hypertension. Specifically, the average blood pressure lowering noted in these trials with the addition of spironolactone in patients with resistant hypertension was 22/10 mm Hg. Trials evaluating spironolactone's role in resistant hypertension treatment have identified hyperkalemia, gynecomastia, and renal insufficiency as the major adverse effects that warrant monitoring. CONCLUSIONS: Spironolactone is an appropriate antihypertensive medication to add to treatment of patients with resistant hypertension (≥3 antihypertensive medications at optimal doses) not at their blood pressure goal. In patients considered to have resistant hypertension, secondary causes should be ruled out. |
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Authors:
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Joel C Marrs |
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Publication Detail:
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Type: Journal Article Date: 2010-10-26 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 44 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1762-9 Citation Subset: IM |
Affiliation:
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Department of Clinical Pharmacy, University of Colorado, Aurora, USA. joel.marrs@ucdenver.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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