{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:37:44Z","timestamp":1767911864491,"version":"3.49.0"},"reference-count":82,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Aortic stiffness is an independent predictor of cardiovascular events in patients with arterial hypertension. Resistant hypertension is often linked to hyperaldosteronism and associated with adverse outcomes. Spironolactone, a mineralocorticoid receptor antagonist, has been shown to reduce both the arterial blood pressure (BP) and aortic stiffness in resistant hypertension. However, the mechanism of aortic stiffness reduction by spironolactone is not well understood. We hypothesized that spironolactone reduces aortic stiffness in resistant hypertension independently of BP change.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients with uncontrolled BP (\u2265140\/90\u00a0mm\u00a0Hg) despite use of \u22653 antihypertensive medications (including diuretics) were prospectively recruited. Participants were started on spironolactone at 25\u00a0mg\/d, and increased to 50\u00a0mg\/d at 4\u00a0weeks while other antihypertensive medications were withdrawn to maintain constant mean BP. Phase\u2010contrast cardiac magnetic resonance imaging of the ascending aorta was performed in 30 participants at baseline and after 6\u00a0months of spironolactone treatment to measure aortic pulsatility, distensibility, and pulse wave velocity. Pulse wave velocity decreased (6.3\u00b12.3\u00a0m\/s to 4.5\u00b11.8\u00a0m\/s,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and pulsatility and distensibility increased (15.9%\u00b15.3% to 22.1%\u00b17.9%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; and 0.28%\u00b10.10%\/mm Hg to 0.40%\u00b10.14%\/mm\u00a0Hg,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001, respectively) following 6\u00a0months of spironolactone.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our results suggest that spironolactone improves aortic properties in resistant hypertension independently of BP, which may support the hypothesis of an effect of aldosterone on the arterial wall. A larger prospective study is needed to confirm our findings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019434","type":"journal-article","created":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T09:13:22Z","timestamp":1630142002000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Spironolactone Reduces Aortic Stiffness in Patients With Resistant Hypertension Independent of Blood Pressure Change"],"prefix":"10.1161","volume":"10","author":[{"given":"Sudeep R.","family":"Aryal","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8463-6537","authenticated-orcid":false,"given":"Mohammed","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4799-3903","authenticated-orcid":false,"given":"Oleg F.","family":"Sharifov","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1113-4421","authenticated-orcid":false,"given":"Megan D.","family":"Coffin","sequence":"additional","affiliation":[{"name":"School of Medicine University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical Center Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishna K.","family":"Gaddam","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Himanshu","family":"Gupta","sequence":"additional","affiliation":[{"name":"Valley Medical Group Paramus NJ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Thomas S.","family":"Denney","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering Auburn University Auburn AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis J.","family":"Dell'Italia","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"},{"name":"VA Medical Center Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-2599","authenticated-orcid":false,"given":"Suzanne","family":"Oparil","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"},{"name":"Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Calhoun","sequence":"additional","affiliation":[{"name":"Vascular Biology and Hypertension Program University of Alabama at Birmingham Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-0224","authenticated-orcid":false,"given":"Steven G.","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL"},{"name":"VA Medical Center Birmingham AL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","first-page":"1","article-title":"Hypertension prevalence and control among adults: United states, 2015\u20102016","volume":"289","author":"Fryar CD","year":"2017","unstructured":"Fryar CD, Ostchega Y, Hales CM, Zhang G, Kruszon\u2010Moran D. 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