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1. Spironolactone

Spironolactone Top results for spironolactone - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 (...) or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for spironolactone The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other

2018 Trip Latest and Greatest

2. Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension?

Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension? Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension? – Clinical Correlations Search Gamechanger? Is Spironolactone the Magic Bullet for Resistant Hypertension? November 9, 2016 8 min read By Amar Parikh, MD Peer Reviewed Welcome to Gamechangers, a series that takes a critical look at the latest in medical literature to answer one important question: would the results of this article change my (...) . The patient is already on maximum doses of a calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEi), and a thiazide-like diuretic, and he refuses any beta blocker as he fears it will worsen his erectile dysfunction. What are your options for additional anti-hypertensives, and would you consider spironolactone? Why Does This Matter? Resistant hypertension (rHTN), defined as suboptimal blood pressure control despite treatment with at least three anti-hypertensives including a thiazide

2016 Clinical Correlations

3. Spironolactone is effective for treating resistant hypertension

Spironolactone is effective for treating resistant hypertension Spironolactone is effective for treating resistant hypertension Discover Portal Discover Portal Spironolactone is effective for treating resistant hypertension Published on 1 December 2015 doi: This trial investigated which drug is best added to high blood pressure (hypertension) treatment if blood pressure has not come down to normal levels after taking three blood pressure lowering drugs. Such “resistant hypertension” accounts (...) for around 10% of all people who have hypertension. The study found that adding spironolactone to the existing three-drug regimen was the most effective treatment and was well-tolerated by patients. Spironolactone is currently recommended by NICE at this fourth stage of treatment, but at half the dose used in this study. The higher dose will increase the cost of prescribing slightly. Potassium levels need to be monitored when using spironolactone as there is a risk they can rise. High levels were

2018 NIHR Dissemination Centre

4. Spironolactone is effective for treating resistant hypertension

Spironolactone is effective for treating resistant hypertension Spironolactone is effective for treating resistant hypertension Discover Portal Discover Portal Spironolactone is effective for treating resistant hypertension Published on 1 December 2015 doi: This trial investigated which drug is best added to high blood pressure (hypertension) treatment if blood pressure has not come down to normal levels after taking three blood pressure lowering drugs. Such “resistant hypertension” accounts (...) for around 10% of all people who have hypertension. The study found that adding spironolactone to the existing three-drug regimen was the most effective treatment and was well-tolerated by patients. Spironolactone is currently recommended by NICE at this fourth stage of treatment, but at half the dose used in this study. The higher dose will increase the cost of prescribing slightly. Potassium levels need to be monitored when using spironolactone as there is a risk they can rise. High levels were

2018 NIHR Dissemination Centre

5. [Spironolactone versus placebo, bisoprolol and doxazosin to determine the optimal treatment for drug-resistant hypertension]. (PubMed)

[Spironolactone versus placebo, bisoprolol and doxazosin to determine the optimal treatment for drug-resistant hypertension]. 26948046 2017 08 08 2018 12 02 1578-8865 42 7 2016 10 Semergen Semergen [Spironolactone versus placebo, bisoprolol and doxazosin to determine the optimal treatment for drug-resistant hypertension]. e108-e109 S1138-3593(16)00049-6 10.1016/j.semerg.2016.01.017 Divisón Garrote J A JA Atención Primaria, Centro de Salud Casas Ibáñez, Casas-Ibáñez, Albacete, España (...) ; Universidad Católica San Antonio de Murcia, Murcia, España. Electronic address: jadivison@telefonica.net. Escobar Cervantes C C Servicio de Cardiología, Hospital La Paz, Madrid, España. spa Journal Article Comment Espironolactona versus placebo, bisoprolol y doxazosina para determinar el tratamiento óptimo de hipertensión resistente a fármacos. 2016 03 03 Spain Semergen 9610769 1138-3593 0 Antihypertensive Agents 27O7W4T232 Spironolactone NW1291F1W8 Doxazosin Y41JS2NL6U Bisoprolol IM Lancet. 2015 Nov

2017 Semergen

6. Spironolactone for the treatment of acne in women, a retrospective study of 110 patients (PubMed)

Spironolactone for the treatment of acne in women, a retrospective study of 110 patients There is limited evidence on the safety and efficacy of spironolactone in the treatment of women with acne. Thus, for many dermatologists spironolactone remains an alternative rather than a mainstay treatment for female patients with acne.An electronic medical records search tool was used to select data from a group of women who received spironolactone to treat acne and were evaluated with the comprehensive (...) acne severity scale (CASS) before treatment and at all follow-up visits. Data points were collected for CASS scores at each follow-up visit, concurrent and previous treatments, and side effects. These data points were used to draw conclusions about the safety and efficacy of spironolactone in this patient population.There were 110 patients that met all eligibility requirements. Of these, 94 patients saw an improvement in their CASS score and 61 patients completely cleared their score to 0

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2017 International journal of women's dermatology

7. Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial (PubMed)

Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial Persistent congestion is associated with worse outcomes in acute heart failure (AHF). Mineralocorticoid receptor antagonists administered at high doses may relieve congestion, overcome diuretic resistance, and mitigate the effects of adverse neurohormonal activation in AHF.To assess the effect of high-dose spironolactone and usual care on N-terminal pro-B-type natriuretic peptide (NT-proBNP (...) ) levels compared with usual care alone.This double-blind and placebo (or low-dose)-controlled randomized clinical trial was conducted in 22 US acute care hospitals among patients with AHF who were previously receiving no or low-dose (12.5 mg or 25 mg daily) spironolactone and had NT-proBNP levels of 1000 pg/mL or more or B-type natriuretic peptide levels of 250 pg/mL or more, regardless of ejection fraction.High-dose spironolactone (100 mg) vs placebo or 25 mg spironolactone (usual care) daily for 96

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2017 JAMA cardiology

8. Comparison of spironolactone and spironolactone plus metformin in the treatment of polycystic ovary syndrome. (PubMed)

Comparison of spironolactone and spironolactone plus metformin in the treatment of polycystic ovary syndrome. The aim of this study was to evaluate and compare the effects of spironolactone and spironolactone plus metformin treatments on body mass index (BMI), hirsutism score, hormone levels, and insulin resistance in women with polycystic ovary syndrome (PCOS). Thirty-seven patients with PCOS were randomly assigned to receive spironolactone 100 mg/d (spironolactone group, 18 patients (...) ) or spironolactone 100 mg/d plus metformin 2000 mg/d (combination group, 19 patients) for 12 months. BMI, modified Ferriman-Gallway score (FGS), serum levels of regarding hormones, and homeostasis model assessment of insulin resistance (HOMA-IR) index were assessed before and after the treatments. Six patients in the spironolactone group and four patients in the combination group reported inter-menstrual vaginal bleeding during treatments. In hirsutism scores, the spironolactone therapy resulted in 25.2

2016 Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology

9. A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients. (PubMed)

A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients. Mineralocorticoid receptor antagonists have beneficial effects on left ventricular remodeling, cardiac fibrosis, and arrhythmia in heart failure, but efficacy and safety in dialysis patients is less clear. We evaluated the effect of spironolactone on left ventricular mass (LVM), an independent predictor of all-cause and cardiovascular mortality, in hemodialysis patients (...) . In this placebo-controlled, parallel-group trial, 97 hemodialysis patients (23% female; mean age 60.3 years) were randomized to spironolactone 50 mg once daily (n=50) or placebo (n=47). The primary efficacy endpoint was change in LVM index (LVMi) from baseline to 40 weeks as determined by cardiac magnetic resonance imaging. Safety endpoints were development of hyperkalemia and change in residual renal function. There was no significant change in LVMi in participants randomized to spironolactone compared

2019 Kidney International

10. Combined low-dose spironolactone plus vitamin E vs. vitamin E monotherapy on insulin resistance, noninvasive indices of steatosis and fibrosis and adipokine levels in nonalcoholic fatty liver disease: A randomized controlled trial

Combined low-dose spironolactone plus vitamin E vs. vitamin E monotherapy on insulin resistance, noninvasive indices of steatosis and fibrosis and adipokine levels in nonalcoholic fatty liver disease: A randomized controlled trial The beneficial effects of mineralocorticoid receptor blockade by spironolactone have been shown in animal models of non-alcoholic fatty liver disease (NAFLD). The aim of the present 52-week randomized controlled trial was to compare the effects of low-dose (...) spironolactone and vitamin E combination with those of vitamin E monotherapy on insulin resistance, non-invasive indices of hepatic steatosis and fibrosis, liver function tests, circulating adipokines and hormones in patients with histologically confirmed NAFLD. Homeostasis model of assessment of insulin resistance (HOMA-IR) and non-invasive indices of steatosis and fibrosis were calculated. Analysis was intention-to-treat. NAFLD liver fat score, an index of steatosis, decreased significantly

2017 EvidenceUpdates

11. Effect of Spironolactone on Exercise Tolerance and Arterial Function in Older Adults with Heart Failure with Preserved Ejection Fraction

Effect of Spironolactone on Exercise Tolerance and Arterial Function in Older Adults with Heart Failure with Preserved Ejection Fraction To evaluate the effects of an aldosterone antagonist on exercise intolerance in older adults with heart failure and preserved ejection fraction (HFpEF).Randomized, placebo-controlled, double-blind trial.Academic medical center, Winston-Salem, North Carolina.Older adults (N = 80, aged 71 ± 1; 80% female) with stable compensated HFpEF and controlled blood (...) pressure (BP).Participants were randomized into a 9-month treatment of spironolactone 25 mg/d vs placebo. Assessments were peak exercise oxygen consumption (VO2 ), 6-minute walk test, Minnesota Living with Heart Failure Questionnaire (MLHFQ), cardiac magnetic resonance imaging, Doppler echocardiography, and vascular ultrasound.Seventy-one participants completed the trial: 37 in the spironolactone group and 34 in the placebo group. Adherence according to pill count was excellent (spironolactone 95

2017 EvidenceUpdates

12. Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of type 2 diabetes, in the factorial design, double-blind, randomized controlled VaSera trial. (PubMed)

Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of type 2 diabetes, in the factorial design, double-blind, randomized controlled VaSera trial. The aims of the present study were to explore whether a long-term intervention with dietary nitrate [(NO3- ), a potential tolerance-free source of beneficial vasoactive nitric oxide] and spironolactone (to oppose aldosterone's potential deleterious cardiovascular effects) improve cardiac (...) structure/function, independently of blood pressure (BP), in patients with/at risk of type 2 diabetes (a population at risk of heart failure).A subsample of participants in our double-blind, randomized, factorial-design intervention (VaSera) trial of active beetroot juice as a nitrate source (≤11.2 mmol) or placebo (nitrate depleted) beetroot juice, and either ≤50 mg spironolactone or ≤16 mg doxazosin (control), had transthoracic cardiac ultrasounds at baseline (n = 105), and at 3 months and 6 months (n

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2019 British journal of clinical pharmacology

13. Comment on 'Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of type 2 diabetes, in the factorial design, double-blind, randomised controlled VaSera trial' by Faconti et al. (PubMed)

Comment on 'Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of type 2 diabetes, in the factorial design, double-blind, randomised controlled VaSera trial' by Faconti et al. 30614030 2019 01 07 1365-2125 2019 Jan 04 British journal of clinical pharmacology Br J Clin Pharmacol Comment on 'Cardiac effects of 6 months' dietary nitrate and spironolactone in patients with hypertension and with/at risk of type 2 diabetes, in the factorial

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2019 British journal of clinical pharmacology

14. Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension. (PubMed)

Urine Haptoglobin and Haptoglobin-Related Protein Predict Response to Spironolactone in Patients With Resistant Hypertension. Resistant hypertension prevalence is progressively increasing, and prolonged exposure to suboptimal blood pressure control results in higher cardiovascular risk and end-organ damage. Among various antihypertensive agents, spironolactone seems the most effective choice to treat resistant hypertension once triple therapy including a diuretic fails. However success in blood (...) pressure control is not guaranteed, adverse effects are not negligible, and no clinical tools are available to predict patient's response. Complementary to our previous study of resistant hypertension metabolism, here we investigated urinary proteome changes with potential capacity to predict response to spironolactone. Twenty-nine resistant hypertensives were included. A prospective study was conducted and basal urine was collected before spironolactone administration. Patients were classified

2019 Hypertension

15. Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction: A meta-analysis of randomized clinical trials. (PubMed)

Efficacy and safety of spironolactone in the heart failure with mid-range ejection fraction and heart failure with preserved ejection fraction: A meta-analysis of randomized clinical trials. Recent studies have shown the efficacy for using spironolactone to treat heart failure with reduced ejection fraction (HFrEF), but the efficacy of spironolactone for heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF) is unclear. This meta (...) -analysis investigated the efficacy and safety of spironolactone in patients with HFmrEF and HFpEF.We searched several databases including PubMed and the Cochrane Collaboration, for randomized controlled trials (RCTs) that assessed spironolactone treatment in HFmrEF and HFpEF. Eleven RCTs including 4539 patients were included. Spironolactone reduced hospitalizations (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.73-0.95; P = .006), improved New York Heart Association functional classifications

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2019 Medicine

16. Primary |Care Corner with Geoffrey Modest MD: Spironolactone helps heart failure with preserved EF

Primary |Care Corner with Geoffrey Modest MD: Spironolactone helps heart failure with preserved EF Primary |Care Corner with Geoffrey Modest MD: Spironolactone helps heart failure with preserved EF | BMJ EBM Spotlight by by Dr Geoffrey Modest One concern about patients having heart failure with preserved ejection fraction (HFpEF) is the dearth of effective treatments for long-term outcomes in this quite common problem. One of the most influential studies was the , which found a nonsignificant (...) benefit for spironolactone. A subsequent post hoc analysis (see below), however, found a significant outcome benefit ​ from spironolactone in those patients enrolled from the United States, Canada, Brazil, and Argentina (the Americas) but not in those from Russia and Georgia. Details, in brief, of TOPCAT: — 3445 participants with symptomatic HFpEF (EF>45%) were randomized to spironolactone vs placebo, mean dose 28mg/d, followed 3.3 years, around 80% also on a diuretic, ACE-I/ARB, and/or b-blocker

2017 Evidence-Based Medicine blog

17. ACP Journal Club. In resistant hypertension, add-on spironolactone reduced SBP more than placebo, doxazosin, or bisoprolol over 12 wk. (PubMed)

ACP Journal Club. In resistant hypertension, add-on spironolactone reduced SBP more than placebo, doxazosin, or bisoprolol over 12 wk. 26882301 2016 06 14 2018 12 02 1539-3704 164 4 2016 Feb 16 Annals of internal medicine Ann. Intern. Med. ACP Journal Club. In resistant hypertension, add-on spironolactone reduced SBP more than placebo, doxazosin, or bisoprolol over 12 wk. JC16 10.7326/ACPJC-2016-164-4-016 Rosenberg Mark M Stephens Elizabeth E eng Journal Article Comment United States Ann Intern (...) Med 0372351 0003-4819 0 Adrenergic alpha-1 Receptor Antagonists 0 Adrenergic beta-1 Receptor Antagonists 0 Mineralocorticoid Receptor Antagonists 27O7W4T232 Spironolactone NW1291F1W8 Doxazosin Y41JS2NL6U Bisoprolol AIM IM Lancet. 2015 Nov 21;386(10008):2059-68 26414968 Adrenergic alpha-1 Receptor Antagonists therapeutic use Adrenergic beta-1 Receptor Antagonists therapeutic use Bisoprolol therapeutic use Doxazosin therapeutic use Female Humans Hypertension drug therapy Male Mineralocorticoid

2016 Annals of Internal Medicine

18. The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. (PubMed)

The SEISICAT study: a pilot study assessing efficacy and safety of spironolactone in cats with congestive heart failure secondary to cardiomyopathy. The pathophysiology of heart failure involves activation of several neurohormonal systems including the renin-angiotensin-aldosterone system. The mineralocorticoid receptor antagonist spironolactone has been shown to be beneficial in humans and dogs with heart failure. The objective of this pilot study was to investigate the efficacy and safety (...) of spironolactone in cats with heart failure secondary to cardiomyopathy already treated with furosemide and an angiotensin-converting enzyme inhibitor.Twenty cats with heart failure due to cardiomyopathy.The study was a double-blind, randomised, placebo-controlled, multicentre clinical study assessing the effect of spironolactone on survival and clinical parameters in cats with heart failure due to cardiomyopathy. The primary end point was mortality, defined as death (spontaneous or by euthanasia) due

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2018 Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology

19. Pulmonary vein isolation combined with spironolactone or renal sympathetic denervation in patients with chronic kidney disease, uncontrolled hypertension, paroxysmal atrial fibrillation, and a pacemaker. (PubMed)

Pulmonary vein isolation combined with spironolactone or renal sympathetic denervation in patients with chronic kidney disease, uncontrolled hypertension, paroxysmal atrial fibrillation, and a pacemaker. Atrial fibrillation (AF) commonly occurs in chronic kidney disease (CKD), occasioning adverse outcomes. Merging pulmonary vein isolation (PVI) and renal sympathetic denervation (RSD) may decrease the recurrence of AF in subjects with CKD and uncontrolled hypertension. We considered that RSD (...) could reduce the recurrence of AF in patients with CKD by modulating sympathetic hyperactivity. We aimed to evaluate the impact of RSD or spironolactone 50 mg/day associated with PVI in reducing systolic blood pressure (BP), AF recurrence, and AF burden in patients with a history of paroxysmal AF and mild CKD.This was a single-center, prospective, longitudinal, randomized, double-blind study. The individuals were randomly divided into two groups (PVI + spironolactone, n = 36, and PVI + RSD, n = 33

2018 Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

20. Organ damage changes in patients with resistant hypertension randomized to renal denervation or spironolactone: The DENERVHTA (Denervación en Hipertensión Arterial) study. (PubMed)

Organ damage changes in patients with resistant hypertension randomized to renal denervation or spironolactone: The DENERVHTA (Denervación en Hipertensión Arterial) study. Renal denervation and spironolactone have both been proposed for the treatment of resistant hypertension, but their effects on preclinical target organ damage have not been compared. Twenty-four patients with 24-hour systolic blood pressure ≥140 mm Hg despite receiving three or more full-dose antihypertensive drugs, one (...) a diuretic, were randomized to receive spironolactone or renal denervation. Changes in 24-hour blood pressure, urine albumin excretion, arterial stiffness, carotid intima-media thickness, and left ventricular mass index were evaluated at 6 months. Mean baseline-adjusted difference between the two groups (spironolactone vs renal denervation) at 6 months in 24-hour systolic blood pressure was -17.9 mm Hg (95% confidence interval [CI], -30.9 to -4.9; P = .01). Mean baseline-adjusted change in urine albumin

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2018 Journal of clinical hypertension (Greenwich, Conn.)

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