In patients with resistant hypertension, amiloride and spironolactone have similar — and impressive — effects on home blood pressure.
In a 2015 trial, researchers showed that spironolactone was superior to doxazosin and bisoprolol as a second-line agent for lowering blood pressure (BP) among patients with resistant hypertension (NEJM JW Gen Med Oct 15 2015 and Lancet 2015; 386:2059). However, widespread clinical use of spironolactone is hampered by side effects, including gynecomastia and hyperkalemia. Amiloride, a potassium-sparing diuretic, might be a viable alternative, but its comparative BP-lowering effect is unknown.
In a South Korean trail, investigators randomized 118 patients with resistant hypertension after a trial of triple therapy (i.e., olmesartan, amlodipine, and hydrochlorothiazide) to amiloride (5 mg once daily) or spironolactone (12.5 mg once daily); dose…
Reviewing Author
DisclosuresGrant/Research SupportAmerican Heart Association; NIH/National Heart, Lung, and Blood Institute; NIH/National Institute on Minority Health and Health Disparities
Editorial BoardsHypertension
Leadership Positions in Professional SocietiesAmerican Heart Association (President of the Greater Boston Board of Directors)
DisclosuresGrant/Research SupportAmerican Heart Association; NIH/National Heart, Lung, and Blood Institute; NIH/National Institute on Minority Health and Health Disparities
Editorial BoardsHypertension
Leadership Positions in Professional SocietiesAmerican Heart Association (President of the Greater Boston Board of Directors)