Serum potassium levels predict blood pressure response to aldosterone antagonists in resistant hypertension

Gadi Shlomai, Tal Sella, Yehonatan Sharabi, Avshalom Leibowitz, Ehud Grossman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study was to identify factors associated with the blood pressure (BP) response to spironolactone - aldosterone receptor antagonist as an add-on therapy in patients with resistant hypertension (HTN). We retrospectively reviewed the data of subjects with resistant HTN who were treated with add-on spironolactone in a large HTN clinic. A paired Student's t-Test was used to assess the differences between the BP values before and during spironolactone administration, and multivariate analysis was used to assess the predictors of a satisfactory BP response (a decrease in systolic BP >10%). We analyzed the data of 48 hypertensive participants. The add-on spironolactone therapy had a significant BP-lowering effect in both systolic and diastolic BP values (P<0.01 for both). Baseline serum potassium levels of <4.5 mEq l -1 were associated with a satisfactory BP response (P<0.01). Furthermore, every decrement of 1 mEq l -1 of serum potassium was independently associated with a fivefold higher rate of achieving a satisfactory BP response to spironolactone therapy (P=0.024). Additional factors independently associated with an improved systolic BP response were old age (P=0.033), body mass index (P=0.033) and high baseline systolic BP (P=0.004). Our results support the use of add-on spironolactone therapy in patients with resistant HTN who are elderly and obese and have high systolic BP and serum potassium levels <4.5 mEq l -1.

Original languageEnglish
Pages (from-to)1037-1041
Number of pages5
JournalHypertension Research
Volume37
Issue number12
DOIs
StatePublished - 11 Dec 2014

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