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Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial.
Wei, Fang-Fei; Pellicori, Pierpaolo; Ferreira, João Pedro; González, Arantxa; Mariottoni, Beatrice; An, De-Wei; Verdonschot, Job A J; Liu, Chen; Ahmed, Fozia Z; Petutschnigg, Johannes; Rossignol, Patrick; Heymans, Stephane; Cuthbert, Joe; Girerd, Nicolas; Clark, Andrew L; Li, Yan; Nawrot, Tim S; Díez, Javier; Zannad, Faiez; Cleland, John G F; Staessen, Jan A.
Afiliación
  • Wei FF; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
  • Pellicori P; Non-Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED), Mechelen, Belgium.
  • Ferreira JP; Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK.
  • González A; Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto Portugal, Porto, Portugal.
  • Mariottoni B; Portugal Heart Failure Clinics, Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
  • An DW; Program of Cardiovascular Diseases, CIMA. Universidad de Navarra and IdiSNA, Pamplona, Spain CIBERCV, Carlos III Institute of Health, Madrid, Spain.
  • Verdonschot JAJ; Department of Cardiology, Cortona Hospital, Arezzo, Italy.
  • Liu C; Non-Profit Research Association Alliance for the Promotion of Preventive Medicine (APPREMED), Mechelen, Belgium.
  • Ahmed FZ; Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Petutschnigg J; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Rossignol P; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
  • Heymans S; Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
  • Cuthbert J; Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine Berlin, Berlin Institute of Health and German Center for Cardiovascular Research, Partner Site Berlin, Berlin, Germany.
  • Girerd N; Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France.
  • Clark AL; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Li Y; Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, Hull, UK.
  • Nawrot TS; Université de Lorraine, Inserm, Centre d'Investigation Clinique Plurithématique 1433, U1116, CHRU de Nancy, F-CRIN INI-CRCT, Nancy, France.
  • Díez J; Department of Cardiology, University of Hull, Castle Hill Hospital, Cottingham, East Riding of Yorkshire, Hull, UK.
  • Zannad F; Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
  • Cleland JGF; Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
  • Staessen JA; Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium.
Hypertens Res ; 47(11): 3225-3236, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39242826
ABSTRACT
None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to usual treatment with or without spironolactone (25-50 mg/day). The current substudy included 113 controls and 114 patients assigned spironolactone, who all completed the incremental shuttle walk test at baseline and months 1 and 9. Quality of life (QoL) was assessed by EQ5D questionnaire. Between-group differences (spironolactone minus control [Δs]) were analyzed by repeated measures ANOVA with adjustment for baseline and, if appropriate, additionally for sex, age and body mass index. Δs in the pre-exercise systolic/diastolic BP were -8.00 mm Hg (95% CI, -11.6 to -4.43)/-0.85 mm Hg (-2.96 to 1.26) at month 1 and -9.58 mm Hg (-14.0 to -5.19)/-3.84 mm Hg (-6.22 to -1.47) at month 9. Δs in the post-exercise systolic/diastolic BP were -8.08 mm Hg (-14.2 to -2.01)/-2.07 mm Hg (-5.79 to 1.65) and -13.3 mm Hg (-19.9 to -6.75)/-4.62 mm Hg (-8.07 to -1.17), respectively. For completed shuttles, Δs at months 1 and 9 were 2.15 (-0.10 to 4.40) and 2.49 (-0.79 to 5.67), respectively. Δs in QoL were not significant. The correlations between the exercise-induced BP increases and the number of completed shuttles were similar in both groups. In conclusion, in patients at increased risk of developing HF, spironolactone reduced the pre- and post-exercise BP, but did not improve exercise capacity or QoL.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Espironolactona / Presión Sanguínea / Ejercicio Físico / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hypertens Res Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Calidad de Vida / Espironolactona / Presión Sanguínea / Ejercicio Físico / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Hypertens Res Asunto de la revista: ANGIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido