11 reasons to use spironolactone – scientific reports review Review article
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Published:
Jun 30, 2015
Keywords:
spironolactone, aldosterone, mineralocorticoid receptor antagonists, hypertension, heart failure, cardiovascular disease
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Abstract
Spironolactone is the oldest and best studied drug from the class of mineralocorticoid receptor antagonists, which are increasingly commonly used in the treatment of patients with cardiovascular disease, particularly hypertension, primary aldosteronism, and heart failure. Spironolactone is often considered most useful in aldosteronism, systolic heart failure, and resistant hypertension but it also has some other advantages that make it a valuable choice in a number of other clinical situations. In the present article, the most important trial evidence regarding spironolactone use in various patient groups was reviewed.
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How to Cite
Jędrusik , P. (2015). 11 reasons to use spironolactone – scientific reports review. Medycyna Faktow (J EBM), 8(2(27), 30-38. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2308
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References
1. Pitt B., Zannad F., Remme W.J. et al.: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N. Engl. J. Med. 1999; 341: 709-717.
2. Vizzardi E., Nodari S., Caretta G. et al.: Effects of spironolactone on long-term mortality and morbidity in patients with heart failure and mild or no symptoms. Am. J. Med. Sci. 2014; 347: 271-276.
3. Chapman N., Dobson J., Wilson S. et al.: Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension 2007; 49: 1-7.
4. Vaclavik J., Sedlak R., Plachy M. et al.: Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension 2011; 57: 1069-1075.
5. Rodilla E., Costa J.A., Perez-Lahiguera F. et al.: Spironolactone and doxazosin treatment in patients with resistant hypertension. Rev. Esp. Cardiol. 2009; 62: 158-166.
6. Viera A.J.: Resistant hypertension. J. Am. Board. Fam. Med. 2012; 25: 487-495.
7. Batterink J., Stabler S.N., Tejani A.M. et al.: Spironolactone for hypertension. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD008169. [DOI: 10.1002/14651858.CD008169.pub2].
8. Adlin E.V., Marks A.D., Channick B.J.: Spironolactone and hydrochlorothiazide in essential hypertension. Arch. Intern. Med. 1972; 130: 855-858.
9. Kreeft J.H., Larochelle P., Ogilive R.I.: Comparison of chlorthalidone and spironolactone in low-renin essential hypertension. Can. Med. Assoc. J. 1983; 128: 31-34.
10. Karlberg B.E., Kagedal B., Tegler L. et al.: Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity. Am. J. Cardiol. 1976; 37: 642-649.
11. Henry M., Wehrlen M., Pelletier B. et al.: Spironolactone versus nifedipine in essential hypertension. Am. J. Cardiol. 1990; 65: 36K-38K.
12. Plouin P.F., Battaglia C., Alhenc-Gélas F. et al.: Are angiotensin converting enzyme inhibition and aldosterone antagonism equivalent in hypertensive patients over fifty? Am. J. Hypertens. 1991; 4: 356-362.
13. Catena C., Colussi G.L., Lapenna R. et al.: Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918.
14. Gaddam K., Corros C., Pimenta E. et al.: Rapid reversal of left ventricular hypertrophy and intracardiac volume overload in patients with resistant hypertension and hyperaldosteronism: a prospective clinical study. Hypertension 2010; 55: 1137-1142.
15. Williams R.S., deLemos J.A., Dimas V. et al.: Effect of spironolactone on patients with atrial fibrillation and structural heart disease. Clin. Cardiol. 2011; 34: 415-419.
16. Gaddam K., Pimenta E., Thomas S.J. et al.: Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J. Hum. Hypertens. 2010; 24: 532-537.
17. Bianchi S., Bigazzi R., Campese V.M.: Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int. 2006; 70: 2116-2123.
18. Navaneethan S.D., Nigwekar S.U., Sehgal A.R. et al.: Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 2009; 4: 542-551.
19. Schjoedt K.J., Rossing K., Juhl T.R. et al.: Beneficial impact of spironolactone on nephrotic range albuminuria in diabetic nephropathy. Kidney Int. 2006; 70: 536-542.
20. Oxlund C., Henriksen J., Tarnow L. et al.: Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomised clinical trial. J. Hypertens. 2013; 31: 2094-2102.
21. Bomback A.S., Muskala P., Bald E. et al.: 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. Clin. Nephrol. 2009; 72: 449-456.
22. Roongsritong C., Sutthiwan P., Bradley J. et al.: Spironolactone improves diastolic function in the elderly. Clin. Cardiol. 2005; 28: 484-487.
23. Sato A., Hayashi M., Saruta T.: Relative long-term effects of spironolactone in conjunction with angiotensin-converting enzyme inhibitors on left ventricular mass and diastolic function in patients with essential hypertension. Hypertens. Res. 2002; 25: 837-842.
24. Gupta A., Schiros C.G., Gaddam K.K. et al.: Effect of spironolactone on diastolic function in hypertensive left ventricular hypertrophy. J. Hum. Hypertens. 2015; 29: 241-246.
25. Edelmann F., Wachter R., Schmidt A.G. et al.: Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA 2013; 309: 781-791.
26. Pitt B., Pfeffer M.A., Assmann S.F. et al.: Spironolactone for heart failure with preserved ejection fraction. N. Engl. J. Med. 2014; 370: 1383-1392.
27. Pfeffer M.A., Claggett B., Assmann S.F. et al.: Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation 2015; 131: 34-42.
28. Zile M.R., Gaasch W.H.: UpToDate: Treatment and prognosis of diastolic heart failure, 2014 [online: www.uptodate.com/contents/treatment-and- prognosis-of-diastolic-heart-failure].
29. Yemisci A., Gorgulu A., Piskin S.: Effects and side-effects of spironolactone therapy in women with acne. J. Eur. Acad. Dermatol. Venereol. 2005; 19: 163-166.
30. Shaw J.C.: Low-dose adjunctive spironolactone in the treatment of acne in women: a retrospective analysis of 85 consecutively treated patients. J. Am. Acad. Dermatol. 2000; 43: 498-502.
31. Sinclair R., Wewerinke M., Jolley D.: Treatment of female pattern hair loss with oral antiandrogens. Br. J. Dermatol. 2005; 152: 466-473.
32. Radosh L.: Drug treatments for polycystic ovary syndrome. Am. Fam. Physician 2009; 79: 671-676.
33. Zulian E., Sartorato P., Benedini S.: Spironolactone in the treatment of polycystic ovary syndrome: effects on clinical features, insulin sensitivity and lipid profile. J. Endocrinol. Invest. 2005; 28: 49-53.
34. Maron B., Leopold J.: Aldosterone receptor antagonists: effective but often forgotten. Circulation 2010; 121: 934-939.
35. Khosla N., Kalaitzidis R., Bakris G.L.: Predictors of hyperkalemia risk following hypertension control with aldosterone blockade. Am. J. Nephrol. 2009; 30: 418-424.
36. Engbaek M., Hjerrild M., Hallas J. et al.: The effect of low-dose spironolactone on resistant hypertension. J. Am. Soc. Hypertens. 2010; 4: 290-294.
37. Heshka J., Ruzicka M., Hiremath S. et al.: Spironolactone for difficult to control hypertension in chronic kidney disease: an analysis of safety and efficacy. J. Am. Soc. Hypertens. 2010: 4: 295-301.
38. Juurlink D.N., Mamdani M.M., Lee D.S. et al.: Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N. Engl. J. Med. 2004; 351: 543-551.
39. Wei L., Struthers A.D., Fahey T. et al.: Spironolactone use and renal toxicity: population based longitudinal analysis. BMJ 2010; 340: c1768.
40. Edwards N.C., Steeds R.P., Chue C.D. et al.: The safety and tolerability of spironolactone in patients with mild to moderate chronic kidney disease. Br. J. Clin. Pharmacol. 2012; 73: 447-454.
41. Ruilope L.M.: Safety aspects of aldosterone-blocking drugs. Eur. Heart J. Suppl. 2011; 13(suppl. B): B40-B42.
42. Mackenzie I.S., MacDonald T.M., Thompson A. et al.: Spironolactone and risk of incident breast cancer in women older than 55 years: retrospective, matched cohort study. BMJ 2012; 345: e4447.
2. Vizzardi E., Nodari S., Caretta G. et al.: Effects of spironolactone on long-term mortality and morbidity in patients with heart failure and mild or no symptoms. Am. J. Med. Sci. 2014; 347: 271-276.
3. Chapman N., Dobson J., Wilson S. et al.: Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension 2007; 49: 1-7.
4. Vaclavik J., Sedlak R., Plachy M. et al.: Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension 2011; 57: 1069-1075.
5. Rodilla E., Costa J.A., Perez-Lahiguera F. et al.: Spironolactone and doxazosin treatment in patients with resistant hypertension. Rev. Esp. Cardiol. 2009; 62: 158-166.
6. Viera A.J.: Resistant hypertension. J. Am. Board. Fam. Med. 2012; 25: 487-495.
7. Batterink J., Stabler S.N., Tejani A.M. et al.: Spironolactone for hypertension. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD008169. [DOI: 10.1002/14651858.CD008169.pub2].
8. Adlin E.V., Marks A.D., Channick B.J.: Spironolactone and hydrochlorothiazide in essential hypertension. Arch. Intern. Med. 1972; 130: 855-858.
9. Kreeft J.H., Larochelle P., Ogilive R.I.: Comparison of chlorthalidone and spironolactone in low-renin essential hypertension. Can. Med. Assoc. J. 1983; 128: 31-34.
10. Karlberg B.E., Kagedal B., Tegler L. et al.: Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity. Am. J. Cardiol. 1976; 37: 642-649.
11. Henry M., Wehrlen M., Pelletier B. et al.: Spironolactone versus nifedipine in essential hypertension. Am. J. Cardiol. 1990; 65: 36K-38K.
12. Plouin P.F., Battaglia C., Alhenc-Gélas F. et al.: Are angiotensin converting enzyme inhibition and aldosterone antagonism equivalent in hypertensive patients over fifty? Am. J. Hypertens. 1991; 4: 356-362.
13. Catena C., Colussi G.L., Lapenna R. et al.: Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918.
14. Gaddam K., Corros C., Pimenta E. et al.: Rapid reversal of left ventricular hypertrophy and intracardiac volume overload in patients with resistant hypertension and hyperaldosteronism: a prospective clinical study. Hypertension 2010; 55: 1137-1142.
15. Williams R.S., deLemos J.A., Dimas V. et al.: Effect of spironolactone on patients with atrial fibrillation and structural heart disease. Clin. Cardiol. 2011; 34: 415-419.
16. Gaddam K., Pimenta E., Thomas S.J. et al.: Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J. Hum. Hypertens. 2010; 24: 532-537.
17. Bianchi S., Bigazzi R., Campese V.M.: Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int. 2006; 70: 2116-2123.
18. Navaneethan S.D., Nigwekar S.U., Sehgal A.R. et al.: Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 2009; 4: 542-551.
19. Schjoedt K.J., Rossing K., Juhl T.R. et al.: Beneficial impact of spironolactone on nephrotic range albuminuria in diabetic nephropathy. Kidney Int. 2006; 70: 536-542.
20. Oxlund C., Henriksen J., Tarnow L. et al.: Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomised clinical trial. J. Hypertens. 2013; 31: 2094-2102.
21. Bomback A.S., Muskala P., Bald E. et al.: 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. Clin. Nephrol. 2009; 72: 449-456.
22. Roongsritong C., Sutthiwan P., Bradley J. et al.: Spironolactone improves diastolic function in the elderly. Clin. Cardiol. 2005; 28: 484-487.
23. Sato A., Hayashi M., Saruta T.: Relative long-term effects of spironolactone in conjunction with angiotensin-converting enzyme inhibitors on left ventricular mass and diastolic function in patients with essential hypertension. Hypertens. Res. 2002; 25: 837-842.
24. Gupta A., Schiros C.G., Gaddam K.K. et al.: Effect of spironolactone on diastolic function in hypertensive left ventricular hypertrophy. J. Hum. Hypertens. 2015; 29: 241-246.
25. Edelmann F., Wachter R., Schmidt A.G. et al.: Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA 2013; 309: 781-791.
26. Pitt B., Pfeffer M.A., Assmann S.F. et al.: Spironolactone for heart failure with preserved ejection fraction. N. Engl. J. Med. 2014; 370: 1383-1392.
27. Pfeffer M.A., Claggett B., Assmann S.F. et al.: Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation 2015; 131: 34-42.
28. Zile M.R., Gaasch W.H.: UpToDate: Treatment and prognosis of diastolic heart failure, 2014 [online: www.uptodate.com/contents/treatment-and- prognosis-of-diastolic-heart-failure].
29. Yemisci A., Gorgulu A., Piskin S.: Effects and side-effects of spironolactone therapy in women with acne. J. Eur. Acad. Dermatol. Venereol. 2005; 19: 163-166.
30. Shaw J.C.: Low-dose adjunctive spironolactone in the treatment of acne in women: a retrospective analysis of 85 consecutively treated patients. J. Am. Acad. Dermatol. 2000; 43: 498-502.
31. Sinclair R., Wewerinke M., Jolley D.: Treatment of female pattern hair loss with oral antiandrogens. Br. J. Dermatol. 2005; 152: 466-473.
32. Radosh L.: Drug treatments for polycystic ovary syndrome. Am. Fam. Physician 2009; 79: 671-676.
33. Zulian E., Sartorato P., Benedini S.: Spironolactone in the treatment of polycystic ovary syndrome: effects on clinical features, insulin sensitivity and lipid profile. J. Endocrinol. Invest. 2005; 28: 49-53.
34. Maron B., Leopold J.: Aldosterone receptor antagonists: effective but often forgotten. Circulation 2010; 121: 934-939.
35. Khosla N., Kalaitzidis R., Bakris G.L.: Predictors of hyperkalemia risk following hypertension control with aldosterone blockade. Am. J. Nephrol. 2009; 30: 418-424.
36. Engbaek M., Hjerrild M., Hallas J. et al.: The effect of low-dose spironolactone on resistant hypertension. J. Am. Soc. Hypertens. 2010; 4: 290-294.
37. Heshka J., Ruzicka M., Hiremath S. et al.: Spironolactone for difficult to control hypertension in chronic kidney disease: an analysis of safety and efficacy. J. Am. Soc. Hypertens. 2010: 4: 295-301.
38. Juurlink D.N., Mamdani M.M., Lee D.S. et al.: Rates of hyperkalemia after publication of the Randomized Aldactone Evaluation Study. N. Engl. J. Med. 2004; 351: 543-551.
39. Wei L., Struthers A.D., Fahey T. et al.: Spironolactone use and renal toxicity: population based longitudinal analysis. BMJ 2010; 340: c1768.
40. Edwards N.C., Steeds R.P., Chue C.D. et al.: The safety and tolerability of spironolactone in patients with mild to moderate chronic kidney disease. Br. J. Clin. Pharmacol. 2012; 73: 447-454.
41. Ruilope L.M.: Safety aspects of aldosterone-blocking drugs. Eur. Heart J. Suppl. 2011; 13(suppl. B): B40-B42.
42. Mackenzie I.S., MacDonald T.M., Thompson A. et al.: Spironolactone and risk of incident breast cancer in women older than 55 years: retrospective, matched cohort study. BMJ 2012; 345: e4447.