Cited by 289Obstructive Sleep Apnea ResearchHormonal Regulation and HypertensionApelin-related biomedical research

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Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report

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Gaddam, K, Pimenta, E, Thomas, S J, Cofield, S S, Oparil, S, Harding, S M, Calhoun, D A·2010·Journal of Human Hypertension

DOI 10.1038/jhh.2009.96PMC PMC2891919

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Abstract

Obstructive sleep apnoea (OSA) and hyperaldosteronism are very common in subjects with resistant hypertension. We hypothesized that aldosterone-mediated chronic fluid retention may influence OSA severity in patients with resistant hypertension. We tested this in an open-label evaluation by assessing the changes in the severity of OSA in patients with resistant hypertension after treatment with spironolactone. Subjects with resistant hypertension (clinical blood pressure (BP) >or=140/90 mm Hg on >or=3 antihypertensive medications, including a thiazide diuretic and OSA (defined as an apnoea-hypopnoea index (AHI) >or=15) had full diagnostic, polysomnography before and 8 weeks after spironolactone (25-50 mg a day) was added to their ongoing antihypertensive therapy. In all, 12 patients (mean age 56 years and body mass index 36.8 kg m(-2)) were evaluated. After treatment with spironolactone, the AHI (39.8+/-19.5 vs 22.0+/-6.8 events/h; P<0.05) and hypoxic index (13.6+/-10.8 vs 6.7+/-6.6 events/h; P<0.05), weight and clinic and ambulatory BP were significantly reduced. Plasma renin activity (PRA) and serum creatinine were significantly higher. This study provides preliminary evidence that treatment with a mineralocorticoid receptor antagonist substantially reduces the severity of OSA. If confirmed in a randomized assessment, it will support aldosterone-mediated chronic fluid retention as an important mediator of OSA severity in patients with resistant hypertension.

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Authors: Gaddam, K., Pimenta, E., Thomas, S. J., Cofield, S. S., Oparil, S., Harding, S. M., & Calhoun, D. A.
Affiliations: Ochsner Medical Center (US)
The University of Queensland (AU)
University of Alabama at Birmingham (US)
Corresponding author: Calhoun, D A
ORCID: Cofield, S S
Oparil, S
Calhoun, D A
Venue: Journal of Human Hypertension
Publisher: Springer Science and Business Media LLC
Published: 2009-12-17
Volume: 24
Issue: 8
Pages: 532-537
ISSN: 0950-9240 (ISSN-L)
1476-5527
DOI: 10.1038/jhh.2009.96
PMC: PMC2891919
OpenAlex: W2076462334
Cited by: 289
References: 26
Citations by year: 2026: 10 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 14 · 2021: 12 · 2020: 17 · 2019: 21 · 2018: 19 · 2017: 16 · 2016: 23 · 2015: 25 · 2014: 33 · 2013: 17 · 2012: 22
FWCI: 10.82
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Journal of Human Hypertension (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (R01-HL79040, R01HL079040, R01HL075614, P50HL077100, T32HL007457)
National Center for Research Resources (M01RR00032, M01RR000032)
Topics: Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Health Sciences › Medicine › Pharmacology (medical) › Apelin-related biomedical research
Keywords: spironolactone, obstructive sleep apnea, resistant hypertension, hyperaldosteronism, mineralocorticoid receptor antagonists, aldosterone, fluid retention, apnea-hypopnea index, plasma renin activity, blood pressure
MeSH terms: Blood Pressure, Diuretics, Drug Resistance, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Pilot Projects, Severity of Illness Index, Spironolactone, Treatment Outcome, Polysomnography, Sleep Apnea, Obstructive

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Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report

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