Effect of spironolactone in patients with resistant arterialhypertension in relation to age and sex: Insights from theaspirant trial

Methods. Patients with an office systolic blood pressure (BP) >140 mmHg or diastolic BP >90 mmHg, despite treatment with at least 3 antihypertensive drugs including a diuretic, were randomly assigned to receive spironolactone or a placebo for 8 weeks in a double-blind, placebo-controlled, multicentre trial (ASPIRANT). Background. There are currently limited data on whether the effect of spironolactone in patients with resistant arterial hypertension depends on age and sex. Results. Analyses were done on 55 patients treated with spironolactone and 56 patients treated with placebo. Significant reductions of office systolic BP (-8.9 +/- 6.7 mmHg, P=0.012), 24-h ABPM systolic BP (-7.9 +/- 7.2 mmHg, P=0.032) and ABPM day-time systolic BP (-7.5 +/- 7.1 mmHg) after 8 weeks of spironolactone treatment, compared to placebo, were only observed in patients with a median age 62 years, and is effective to a similar extent in men and women.