{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:01:45Z","timestamp":1791259305346,"version":"4.1.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T00:00:00Z","timestamp":1512604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Recent evidence suggests that the mineralocorticoid receptor antagonist spironolactone should be the preferred fourth-line antihypertensive treatment in resistant hypertension (RHTN). Whether spironolactone improves blood pressure (BP) control in heart failure with preserved ejection fraction (HFpEF) and RHTN is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We identified patients with RHTN, defined as baseline systolic blood pressure (SBP) between 140 and 160 mm Hg on 3 or more medications, in the Americas cohort of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial, in which patients with HFpEF were randomized to spironolactone vs. placebo. We evaluated the effects of spironolactone vs. placebo on BP reduction in this group and related this to the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for heart failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified 403 participants in the Americas with RHTN. Compared to people without RHTN, those with RHTN were more frequently women, non-White, diabetics, with a higher left ventricular ejection fraction and body mass index, and a lower hemoglobin concentration. In the RHTN group, spironolactone resulted in a decrease of SBP: \u22126.1 (\u22128.9, \u22123.3); P &amp;lt; 0.001 and diastolic BP: \u22122.9 (\u22124.6, \u22121.2); P = 0.001 mm Hg during the first 8 months. BP became controlled after 4 weeks in 63% of patients receiving spironolactone vs. 46% receiving placebo (P = 0.003), with similar responses at 8 weeks, 4 and 8 months. Patients with RHTN derived similar overall benefit from spironolactone on the primary outcomes as those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In HFpEF patients with RHTN, spironolactone lowered BP substantially and was associated with similar benefit as those without RHTN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CLINICAL TRIALS REGISTRATION<\/jats:title>\n                    <jats:p>Trial Number NCT00094302 (ClinicalTrials.gov identifier)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpx210","type":"journal-article","created":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T07:09:10Z","timestamp":1512544150000},"page":"407-414","source":"Crossref","is-referenced-by-count":39,"title":["Spironolactone and Resistant Hypertension in Heart Failure With Preserved Ejection Fraction"],"prefix":"10.1093","volume":"31","author":[{"given":"Patrick","family":"Rossignol","sequence":"first","affiliation":[{"name":"INSERM, Centre d\u2019Investigations Cliniques Plurith\u00e9matique 1433 & U1116, Universit\u00e9 de Lorraine, CHRU de Nancy, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Lee","family":"Claggett","sequence":"additional","affiliation":[{"name":"Madison, WI; Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiankang","family":"Liu","sequence":"additional","affiliation":[{"name":"Madison, WI; Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orly","family":"Vardeny","sequence":"additional","affiliation":[{"name":"Minneapolis VA and University of Minnesota School of Medicine, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"University of Michigan School of Medicine, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"INSERM, Centre d\u2019Investigations Cliniques Plurith\u00e9matique 1433 & U1116, Universit\u00e9 de Lorraine, CHRU de Nancy, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Brigham & Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,12,7]]},"reference":[{"key":"2022111419410182000_CIT0001","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2022111419410182000_CIT0002","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jacc.2008.11.013","article-title":"2009 Focused update incorporated into the ACC\/AHA 2005 guidelines for the diagnosis and management of heart failure in adults a report of the American college of cardiology foundation\/american heart 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