Portal de investigação
Spironolactone effect on the blood pressure of patients at risk of developing heart failure: an analysis from the HOMAGE trial
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Collier, T
- Clark, AL
- Mamas, MA
- Brunner-La Rocca, HP
- Heymans, S
- González, A
- Ahmed, FZ
- Petutschnigg, J
- Mujaj, B
- Cuthbert, J
- Rouet, P
- Pellicori, P
- Mariottoni, B
- Cosmi, F
- Edelmann, F
- Thijs, L
- Staessen, JA
- Hazebroek, M
- Verdonschot, J
- Rossignol, P
- Girerd, N
- Cleland, JG
- Zannad, F
Unidades de investigação
Abstract
Aims Uncontrolled blood pressure (BP) increases the risk of developing heart failure (HF). The effect of spironolactone on BP of patients at risk of developing HF is yet to be determined. To evaluate the effect of spironolactone on the BP of patients at risk for HF and whether renin can predict spironolactone's effect. Methods and results HOMAGE (Heart OMics in Aging) was a prospective multicentre randomized open-label blinded endpoint (PROBE) trial including 527 patients at risk for developing HF randomly assigned to either spironolactone (25-50 mg/day) or usual care alone for a maximum of 9 months. Sitting BP was assessed at baseline, Months 1 and 9 (or last visit). Analysis of covariance (ANCOVA), mixed effects models, and structural modelling equations was used. The median (percentile(25-75)) age was 73 (69-79) years, 26% were female, and >75% had history of hypertension. Overall, the baseline BP was 142/78 mmHg. Patients with higher BP were older, more likely to have diabetes and less likely to have coronary artery disease, had greater left ventricular mass (LVM), and left atrial volume (LAV). Compared with usual care, by last visit, spironolactone changed SBP by -10.3 (-13.0 to -7.5) mmHg and DBP by -3.2 (-4.8 to -1.7) mmHg (P < 0.001 for both). A higher proportion of patients on spironolactone had controlled BP <130/80 mmHg (36 vs. 26%; P = 0.014). Lower baseline renin levels predicted a greater response to spironolactone (interaction(P) = 0.041). Conclusion Spironolactone had a clinically important BP-lowering effect. Spironolactone should be considered for lowering blood pressure in patients who are at risk of developing HF.
Dados da publicação
- ISSN/ISSNe:
- 2055-6837, 2055-6845
- Tipo:
- Article
- Páginas:
- 149-156
- Link para outro recurso:
- www.scopus.com
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY Oxford University Press
Citações Recebidas na Web of Science: 3
Citações Recebidas na Scopus: 8
Documentos
- Não há documentos
Filiações
Keywords
- Cardiovascular risk; Hypertension; Spironolactone; Renin
Financiamento
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Citar a publicação
Ferreira J,Collier T,Clark AL,Mamas MA,Brunner HP,Heymans S,González A,Ahmed FZ,Petutschnigg J,Mujaj B,Cuthbert J,Rouet P,Pellicori P,Mariottoni B,Cosmi F,Edelmann F,Thijs L,Staessen JA,Hazebroek M,Verdonschot J,Rossignol P,Girerd N,Cleland JG,Zannad F. Spironolactone effect on the blood pressure of patients at risk of developing heart failure: an analysis from the HOMAGE trial. Eur Heart J Cardiovasc. Pharmacother. 2022. 8. (2):p. 149-156. IF:7,100. (1).
