BACKGROUND AND OBJECTIVE The blocking of aldosterone or angiotensin II receptors improves mortality in patients with chronic heart failure. We explored whether combining losartan and spironolactone would have any added benefit on the known surrogate of mortality by using heart rate variability (HRV) and QT dispersion as our endpoints. METHODS We designed a three-phase, consecutive, randomised...

BACKGROUND Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) patients with heart failure and preserved left ventricular ejection fraction assigned to spironolactone did not achieve a significant reduction in the primary composite outcome (time to cardiovascular death, aborted cardiac arrest, or hospitalization for management of heart failure) compared...

This study evaluated the inhibitory effects of spironolac-tone, a non-selective aldosterone receptor antagonist, on hypertension-induced myocardial fibrosis. Collagen I and III contents was detected in the myocardial tissue of spontaneously hypertensive rats (SHRs) after spironolactone administration. Twenty male SHRs were assigned to the spironolactone group or control group (N = 10 each); 7 W...

Glucocorticoids are widely administered for the treatment of various disorders, although their long-term use results in adverse effects associated with glucocorticoid excess. We investigated the pathophysiological roles of glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs) in the cardiac changes induced by exogenous corticosterone in rats. Corticosterone or vehicle was injecte...

This study tests the hypothesis that aldosterone induces cardiac fibrosis through an increase of cardiac angiotensin II (Ang II) AT1 receptor levels, thereby potentiating the fibrotic effect of Ang II by determining the effects of spironolactone and losartan on cardiac fibrosis, AT1 density, and gene expression in aldosterone-salt-treated rats. Fibrosis was quantified by slot blots of collagen ...

OBJECTIVE We examined the contribution of high blood pressure versus direct mineralocorticoid effects to the progression of kidney inflammation and fibrosis in established experimental deoxycorticosterone-acetate (DOCA)-salt hypertension. METHODS Male Sprague-Dawley rats underwent unilateral nephrectomy and received subcutaneous DOCA pellets as well as 1% NaCl for drinking. After 4 weeks of D...

BACKGROUND Optimal drug treatment for patients with resistant hypertension is undefined. We aimed to test the hypotheses that resistant hypertension is most often caused by excessive sodium retention, and that spironolactone would therefore be superior to non-diuretic add-on drugs at lowering blood pressure. METHODS In this double-blind, placebo-controlled, crossover trial, we enrolled patien...

1. ALDO-DHF STUDY – A NEW INDICATION FOR AN OLD DRUG? Results of the ALDOsterone receptor blockade in Diastolic Heart Failure (ALDO-DHF) were recently presented at the European Society of Cardiology (ESC) meeting in Munich [1]. The multicenter, double-blind randomized, placebo-controlled phase IIb mechanistic study was conducted to test the hypothesis that 12 months treatment with spironolacton...

BACKGROUND Autoregulation of GFR, i.e. maintenance of relative constancy of GFR despite variations in mean arterial pressure (MAP) >80 mmHg, is impaired in diabetic kidney disease; furthermore, some antihypertensive drugs may jeopardize autoregulation. The aim of our study was to establish if spironolactone affects the ability to autoregulate GFR. METHODS Sixteen hypertensive type 1 diabetic ...

The role of spironolactone in resistant hypertension management is unclear. The aim of this prospective trial was to evaluate the antihypertensive effect of spironolactone in patients with true resistant hypertension diagnosed by ambulatory blood pressure monitoring. A total of 175 patients had clinical and complementary exams obtained at baseline and received spironolactone in doses of 25 to 1...