From a clinician’s point of view. Knowledge in a nutshell. Spironolactone – why is it worth using and in whom? Review article

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Robert Olszewski

Abstract

In the last two decades, a lot of attention has focused on the role of spironolactone in therapy of hypertension and cardiovascular disease. It is commonly used in the treatment of hypertension, with or without aldosteronism, and of various forms of heart failure. The Randomized Aldactone Evaluation Studies demonstrated that adding spironolactone to a standard therapy significantly reduced morbidity and mortality in patients with moderate to severe heart failure. Cardiac benefits of spironolactone are now sufficiently well established to warrant routine use of these compounds for treatment of patients in moderate to advanced stages of heart failure. Moreover, it is used in the treatment of resistant forms of hypertension. Spironolactone is a commonly used add-on diuretic that provides incremental benefit for salt-and-water excretion. Although spironolactone is highly effective in patients with heart failure and hypertension, the risk of hyperkalaemia should not be overlooked. These risks can be mitigated through appropriate patient selection and education, dose selection and monitoring potassium concentration.

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Olszewski , R. (2015). From a clinician’s point of view. Knowledge in a nutshell. Spironolactone – why is it worth using and in whom?. Cardiology in Practice, 9(3), 23-30. Retrieved from https://journalsmededu.pl/index.php/kwp/article/view/1335
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