{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:17:57Z","timestamp":1784269077888,"version":"3.55.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2010,10,26]],"date-time":"2010-10-26T00:00:00Z","timestamp":1288051200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To review the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and adverse effects of spironolactone in the treatment of resistant hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>A literature search was conducted using MEDLINE (1966-July 2010), International Pharmaceutical Abstracts (1970-July 2010), and Cochrane database (2009) for the key words spironolactone or resistant hypertension. References cited in the articles were reviewed for additional information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>English-language literature reporting pharmacology data from animal studies and clinical trials evaluating the pharmacology, pharmacokinetics, pharmacodynamics, efficacy data, and adverse effects of spironolactone were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>Spironolactone is a potassium-sparing diuretic with anti-aldosterone effects that are beneficial in the management of hypertension. Spironolactone has shown improvement in 5 prospective studies and 1 retrospective study evaluating its blood pressuring\u2013lowering abilities in patients with resistant hypertension. Specifically, the average blood pressure lowering noted in these trials with the addition of spironolactone in patients with resistant hypertension was 22\/10 mm Hg. Trials evaluating spironolactone's role in resistant hypertension treatment have identified hyperkalemia, gynecomastia, and renal insufficiency as the major adverse effects that warrant monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Spironolactone is an appropriate antihypertensive medication to add to treatment of patients with resistant hypertension (\u22653 antihypertensive medications at optimal doses) not at their blood pressure goal. In patients considered to have resistant hypertension, secondary causes should be ruled out.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1p338","type":"journal-article","created":{"date-parts":[[2010,10,26]],"date-time":"2010-10-26T22:33:39Z","timestamp":1288132419000},"page":"1762-1769","source":"Crossref","is-referenced-by-count":32,"title":["Spironolactone Management of Resistant Hypertension"],"prefix":"10.1177","volume":"44","author":[{"given":"Joel C","family":"Marrs","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, University of Colorado, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2010,10,26]]},"reference":[{"key":"bibr1-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192667"},{"key":"bibr2-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.19.2560"},{"key":"bibr3-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.189141"},{"key":"bibr4-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.36.4.594"},{"key":"bibr5-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000035855.44620.DA"},{"key":"bibr6-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2004.05.017"},{"key":"bibr7-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3280d9434e"},{"key":"bibr8-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2006.02.002"},{"key":"bibr9-aph.1P338","first-page":"713","volume":"20","author":"Hollander W","year":"1959","journal-title":"Circulation"},{"key":"bibr10-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e32832810ed"},{"key":"bibr11-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/16.suppl_N.103"},{"key":"bibr12-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000030935.89559.04"},{"key":"bibr13-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.895235"},{"key":"bibr14-aph.1P338","volume-title":"Aldactone (spironolactone tablets, USP)","author":"Package insert","year":"2008"},{"key":"bibr15-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-005-2345-1"},{"key":"bibr16-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1177\/000331977202301007"},{"key":"bibr17-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197412052912309"},{"key":"bibr18-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/61.suppl_2.S14"},{"key":"bibr19-aph.1P338","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0090-9556(25)08434-X","volume":"22","author":"Los LE","year":"1994","journal-title":"Drug Metab Dispos"},{"key":"bibr20-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(01)02342-1"},{"key":"bibr21-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(03)01032-X"},{"key":"bibr22-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2005.11.016"},{"key":"bibr23-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67185-1"},{"key":"bibr24-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000259805.18468.8c"},{"key":"bibr25-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328014954d"},{"key":"bibr26-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.140988"},{"key":"bibr27-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1159\/000237742"},{"key":"bibr28-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(01)00642-8"},{"key":"bibr29-aph.1P338","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199529030-00004"},{"key":"bibr30-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1042\/cs0640407"},{"key":"bibr31-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.293"},{"key":"bibr32-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1983.56"},{"key":"bibr33-aph.1P338","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-198102000-00001"},{"key":"bibr34-aph.1P338","unstructured":"Walmart Pharmacy. http:\/\/www.walmart.com\/cp\/4-dollar-prescriptions\/546834 (accessed 2010 May 26)."},{"key":"bibr35-aph.1P338","unstructured":"Target Pharmacy. http:\/\/sites.target.com\/site\/en\/health\/page.jsp?contentId=PRD03-004319 (accessed 2010 May 26)."},{"key":"bibr36-aph.1P338","unstructured":"CVS Pharmacy. http:\/\/www.cvscom\/CVSApp\/images\/promotions\/Landingpagesrx\/rx08037_health_sav_pass\/health_savings_pass_medicationlist.pdf (accessed 2010 May 26)."},{"key":"bibr37-aph.1P338","unstructured":"King Soopers Pharmacy. http:\/\/www.kingsoopers.com\/generic\/Pages\/alpha_listing.aspx (accessed 2010 May 26)."},{"key":"bibr38-aph.1P338","unstructured":"US National Institutes of Health, National Heart, Lung, and Blood Institute. 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