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Latest & greatest articles for spironolactone
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Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial. Spironolactone is effective at reducing blood pressure in patients with uncontrolled resistant hypertension. However, the use of spironolactone in patients with chronic kidney disease can be restricted by hyperkalaemia. We evaluated use of the potassium binder patiromer to allow more persistent use (...) of spironolactone in patients with chronic kidney disease and resistant hypertension.In this phase 2 multicentre, randomised, double-blind, placebo-controlled study, we enrolled participants aged 18 years and older with chronic kidney disease (estimated glomerular filtration rate 25 to ≤45 mL/min per 1·73 m2) and uncontrolled resistant hypertension from 62 outpatient centres in ten countries (Bulgaria, Croatia, Georgia, Hungary, Ukraine, France, Germany, South Africa, the UK, and the USA). Patients meeting all
Effect of spironolactone on the progression of coronary calcification in peritoneal dialysis patients: a pilot study. There is evidence that aldosterone plays a role in the pathogenesis of vascular calcification. The aim of this study was to evaluate the effect of spironolactone, a mineralocorticoid receptor antagonist, on the progression of coronary calcification (CC) in peritoneal dialysis patients and to identify the factors involved in this progression.Thirty-three patients with a coronary (...) calcium score (CCS) ≥ 30, detected through multi-detector computed tomography (MDCT) and expressed in Agatston units, were randomly assigned to a group receiving 25mg spironolactone per day for 12 months (spironolactone group) and a control group not receiving this drug. The primary outcome was a percentage change in CCS from baseline to end of the study (relative progression), when a further MDCT was conducted. Patients who had progression of CC were compared with those who did not progress.Sixteen
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
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
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
[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: email@example.com. 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
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
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
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
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
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
Low-dose Spironolactone: Treatment for Osteoarthritis-related Knee Effusion. A Prospective Clinical and Sonographic-based Study To evaluate the effectiveness of spironolactone as a treatment for osteoarthritis (OA)-related knee effusion in comparison to ibuprofen, cold compresses, and placebo.This study was carried out on 200 patients, aged 40 years or older, attending the outpatient clinic of the Rheumatology Department of Sohag University Hospital with unilateral knee effusion related to OA (...) based on clinical examination, musculoskeletal ultrasonography (US), and synovial fluid analysis. In group 1, 50 patients received spironolactone 25 mg daily for 2 weeks; in group 2, 50 patients took ibuprofen 1200 mg daily for 2 weeks; in group 3, 50 patients used cold compresses 2 times daily for 2 weeks; and in group 4, 50 patients received placebo for the same duration. Fluid > 4 mm was considered as effusion. Decrease in fluid to reach below 4-mm thickness was considered complete improvement
Trimethoprim-sulfamethoxazole and risk of sudden death among patients taking spironolactone Trimethoprim-sulfamethoxazole increases the risk of hyperkalemia when used with spironolactone. We examined whether this drug combination is associated with an increased risk of sudden death, a consequence of severe hyperkalemia.We conducted a population-based nested case-control study involving Ontario residents aged 66 years or older who received spironolactone between Apr. 1, 1994, and Dec. 31, 2011 (...) a disease risk index.Of the 11,968 patients who died of sudden death while receiving spironolactone, we identified 328 whose death occurred within 14 days after antibiotic exposure. Compared with amoxicillin, trimethoprim-sulfamethoxazole was associated with a more than twofold increase in the risk of sudden death (adjusted OR 2.46, 95% confidence interval [CI] 1.55-3.90). Ciprofloxacin (adjusted OR 1.55, 95% CI 1.02-2.38) and nitrofurantoin (adjusted OR 1.70, 95% CI 1.03-2.79) were also associated
Spironolactone for heart failure with preserved ejection fraction. Mineralocorticoid-receptor antagonists improve the prognosis for patients with heart failure and a reduced left ventricular ejection fraction. We evaluated the effects of spironolactone in patients with heart failure and a preserved left ventricular ejection fraction.In this randomized, double-blind trial, we assigned 3445 patients with symptomatic heart failure and a left ventricular ejection fraction of 45% or more to receive (...) either spironolactone (15 to 45 mg daily) or placebo. The primary outcome was a composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure.With a mean follow-up of 3.3 years, the primary outcome occurred in 320 of 1722 patients in the spironolactone group (18.6%) and 351 of 1723 patients in the placebo group (20.4%) (hazard ratio, 0.89; 95% confidence interval [CI], 0.77 to 1.04; P=0.14). Of the components of the primary outcome, only
Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. Diastolic heart failure (ie, heart failure with preserved ejection fraction) is a common condition without established therapy, and aldosterone stimulation may contribute to its progression.To assess the efficacy and safety of long-term aldosterone receptor blockade in heart failure with preserved ejection fraction (...) . The primary objective was to determine whether spironolactone is superior to placebo in improving diastolic function and maximal exercise capacity in patients with heart failure with preserved ejection fraction.The Aldo-DHF trial, a multicenter, prospective, randomized, double-blind, placebo-controlled trial conducted between March 2007 and April 2012 at 10 sites in Germany and Austria that included 422 ambulatory patients (mean age, 67 [SD, 8] years; 52% female) with chronic New York Heart Association
Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study. To characterise the risk of admission to hospital for hyperkalaemia in elderly patients treated with trimethoprim-sulfamethoxazole in combination with spironolactone.Population based nested case-control study.Ontario, Canada, from 1 April 1992 to 1 March 2010.Cases were residents of Ontario aged 66 years or above receiving chronic treatment with spironolactone (...) and receipt of a study antibiotic in the preceding 14 days, adjusted for conditions and drugs that may influence risk of hyperkalaemia.During the 18 year study period, 6903 admissions for hyperkalaemia were identified, 306 of which occurred within 14 days of antibiotic use. Of these, 248 (81%) cases were matched to 783 controls. 10.8% (17,859/165,754) of spironolactone users received at least one prescription for trimethoprim-sulfamethoxazole. Compared with amoxicillin, prescription of trimethoprim